{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:22:01Z","timestamp":1772252521744,"version":"3.50.1"},"reference-count":60,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"French Ministry for Europe and Foreign Affairs (MEAE)","award":["SC\/projet_REPAIR N\u00b057\/2020.ipt"],"award-info":[{"award-number":["SC\/projet_REPAIR N\u00b057\/2020.ipt"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Seroprevalence studies are essential to get an accurate estimate of the actual SARS-CoV-2 diffusion within populations. We report on the findings of the first serosurvey conducted in Tunis prior to the implementation of mass vaccination and analyzed factors associated with seropositivity. A household cross sectional survey was conducted (March\u2013April 2021) in Tunis, spanning the end of the second wave and the beginning of the third wave of COVID-19. SARS-CoV-2 specific immunoglobulin G (IgG) antibodies to the spike (S-RBD) or the nucleocapsid (N) proteins were detected by in-house ELISA tests. The survey included 1676 individuals from 431 households. The mean age and sex ratio were 43.3 \u00b1 20.9 years and 0.6, respectively. The weighted seroprevalence of anti-N and\/or anti-S-RBD IgG antibodies was equal to 38.0% (34.6\u201341.5). In multivariate analysis, age under 10, no tobacco use, previous diagnosis of COVID-19, a history of COVID-19 related symptoms and contact with a COVID-19 case within the household, were independently associated with higher SARS-CoV-2 seroprevalence. More than one third of people living in Tunis obtained antibodies to SARS-CoV-2. Further studies are needed to monitor changes in these figures as Tunisian population is confronted to the subsequent epidemic waves and to guide the vaccine strategy.<\/jats:p>","DOI":"10.3390\/diagnostics12040971","type":"journal-article","created":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T22:48:45Z","timestamp":1649803725000},"page":"971","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["COVID-19 in Tunisia (North Africa): Seroprevalence of SARS-CoV-2 in the General Population of the Capital City Tunis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8988-2596","authenticated-orcid":false,"given":"Ines","family":"Cherif","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"},{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghassen","family":"Kharroubi","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"},{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana","family":"Chaabane","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"},{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rihab","family":"Yazidi","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"},{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mongi","family":"Dellagi","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"},{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Ali","family":"Snoussi","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"},{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadok","family":"Salem","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"},{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9882-909X","authenticated-orcid":false,"given":"Soumaya","family":"Marzouki","sequence":"additional","affiliation":[{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wafa","family":"Kammoun Rebai","sequence":"additional","affiliation":[{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4853-9422","authenticated-orcid":false,"given":"Samia","family":"Rourou","sequence":"additional","affiliation":[{"name":"Laboratory of Molecular Microbiology, Vaccinology and Biotechnology Development, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koussay","family":"Dellagi","sequence":"additional","affiliation":[{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"},{"name":"Pasteur Network, Institut Pasteur, 75015 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Ridha","family":"Barbouche","sequence":"additional","affiliation":[{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaouki","family":"Benabdessalem","sequence":"additional","affiliation":[{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3179-1648","authenticated-orcid":false,"given":"Melika","family":"Ben Ahmed","sequence":"additional","affiliation":[{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jihene","family":"Bettaieb","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"},{"name":"Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,13]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021, November 30). Listings of WHO\u2019s Response to COVID-19. Available online: https:\/\/www.who.int\/news\/item\/29-06-2020-covidtimeline."},{"key":"ref_2","unstructured":"World Health Organization (2021, November 30). Weekly Epidemiological Update on COVID-19\u201430 March 2021. Available online: https:\/\/www.who.int\/publications\/m\/item\/weekly-epidemiological-update-on-covid-19\u201431-march-2021."},{"key":"ref_3","unstructured":"WHO (2021, November 30). WHO Coronavirus (COVID-19) Dashboard. Available online: https:\/\/covid19.who.int."},{"key":"ref_4","unstructured":"National Observatory of New and Emerging Diseases (2021, November 30). COVID-19 en Tunisie: Point de Situation a la Date du 07 Juin 2020. Available online: https:\/\/www.onmne.tn\/?p=10229."},{"key":"ref_5","unstructured":"National Observatory of New and Emerging diseases (2021, December 22). Point de Situation sur L\u2019\u00e9pid\u00e9mie D\u2019infections au Nouveau Coronavirus \u00ab COVID-19 \u00bb \u00e0 la Date du 17 Mars 2020. Available online: https:\/\/www.onmne.tn\/?p=10363."},{"key":"ref_6","unstructured":"National Observatory of New and Emerging Diseases (2021, December 22). Bulletin de Veille COVID-19 a la Date du 12 D\u00e9cembre 2021. Available online: https:\/\/www.onmne.tn\/?p=15695."},{"key":"ref_7","unstructured":"Ministry of Health (2022, January 10). Point de Situation en Tunisie\u2014Coronavirus. Available online: http:\/\/coronavirus.rns.tn\/point-de-situation-en-tunisie\/."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s13031-020-00322-9","article-title":"COVID-19 testing acceptability and uptake amongst the Rohingya and host community in Camp 21, Teknaf, Bangladesh","volume":"14","author":"McGowan","year":"2020","journal-title":"Confl. Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e26895","DOI":"10.2196\/26895","article-title":"Public Attitudes and Factors of COVID-19 Testing Hesitancy in the United Kingdom and China: Comparative Infodemiology Study","volume":"1","author":"Lin","year":"2021","journal-title":"JMIR Infodemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e598","DOI":"10.1016\/S2214-109X(21)00026-7","article-title":"Serological evidence of human infection with SARS-CoV-2: A systematic review and meta-analysis","volume":"5","author":"Chen","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"ref_11","unstructured":"World Health Organization (2020). Population-Based Age-Stratified Seroepidemiological Investigation Protocol for COVID-19 Virus Infection, WHO."},{"key":"ref_12","unstructured":"National Institute of Statistics (2022, January 10). Bulletin Mensuel de la Statistique, Septembre 2021. Available online: http:\/\/www.ins.tn\/publication\/bulletin-mensuel-de-la-statistique-septembre-2021."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Benabdessalem, C., Marzouki, S., Hamouda, W.B., Trabelsi, K., Boumaiza, M., Hamouda, S.B., Ouni, R., Bchiri, S., Chaaban, A., and Gdoura, M. (2022, March 05). COVID-19 in Tunisia (North Africa): IgG and IgG Subclass Antibody Responses to SARS-CoV-2 According to Disease Severity [Preprint]. Available online: https:\/\/www.medrxiv.org\/content\/10.1101\/2022.03.01.22271696v1.","DOI":"10.1101\/2022.03.01.22271696"},{"key":"ref_14","unstructured":"National Institute of Statistics (2022, January 10). Recensement G\u00e9n\u00e9ral de la Population et de l\u2019Habitat 2014. Available online: http:\/\/ins.tn\/enquetes\/recensement-general-de-la-population-et-de-lhabitat-2014."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1093\/aje\/kwaa174","article-title":"Adjusting Coronavirus Prevalence Estimates for Laboratory Test Kit Error","volume":"190","author":"Sempos","year":"2020","journal-title":"Am. J. Epidemiol."},{"key":"ref_16","unstructured":"Ritchie, H., Ortiz-Ospina, E., Beltekian, D., Mathieu, E., Hasell, J., Macdonald, B., Giattino, C., Appel, C., Rod\u00e9s-Guirao, L., and Roser, M. (2021, December 14). Coronavirus Pandemic (COVID-19). Available online: https:\/\/ourworldindata.org\/coronavirus."},{"key":"ref_17","unstructured":"Centers for Disease Control and Prevention (2022, January 12). Delta Variant: What We Know about the Science, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/variants\/delta-variant.html."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e007271","DOI":"10.1136\/bmjgh-2021-007271","article-title":"SARS-CoV-2 antibody prevalence in Sierra Leone, March 2021: A cross-sectional, nationally representative, age-stratified serosurvey","volume":"6","author":"Barrie","year":"2021","journal-title":"BMJ Glob. Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"101172","DOI":"10.1016\/j.eclinm.2021.101172","article-title":"Community SARS-CoV-2 seroprevalence before and after the second wave of SARS-CoV-2 infection in Harare, Zimbabwe","volume":"41","author":"Fryatt","year":"2021","journal-title":"eClinicalMedicine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1007\/s10654-021-00749-1","article-title":"Nationwide seroprevalence of antibodies against SARS-CoV-2 in Israel","volume":"36","author":"Reicher","year":"2021","journal-title":"Eur. J. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3025","DOI":"10.1038\/s41467-021-23233-6","article-title":"Prevalence of SARS-CoV-2 antibodies in France: Results from nationwide serological surveillance","volume":"12","author":"Jones","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1093\/ije\/dyab077","article-title":"Seroprevalence of COVID-19 infection in the Emirate of Abu Dhabi, United Arab Emirates: A population-based cross-sectional study","volume":"50","author":"Alsuwaidi","year":"2021","journal-title":"Int. J. Epidemiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.ijid.2021.09.062","article-title":"Seroprevalence of SARS-CoV-2 antibodies in the general population of Oman: Results from four successive nationwide sero-epidemiological surveys","volume":"112","author":"Kurup","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"724398","DOI":"10.3389\/fpubh.2021.724398","article-title":"Seroprevalence of SARS-CoV-2 Infection in the Colombo Municipality Region, Sri Lanka","volume":"9","author":"Jeewandara","year":"2021","journal-title":"Front. Public Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e925","DOI":"10.1016\/S2214-109X(21)00173-X","article-title":"Seroprevalence of anti-SARS-CoV-2 antibodies in Iquitos, Peru in July and August, 2020: A population-based study","volume":"9","author":"Calampa","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"ofaa550","DOI":"10.1093\/ofid\/ofaa550","article-title":"Severe Acute Respiratory Syndrome Coronavirus 2 Seroprevalence Among Adults in a Tropical City of the Caribbean Area, Colombia: Are We Much Closer to Herd Immunity Than Developed Countries?","volume":"7","author":"Mattar","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.3201\/eid2706.210568","article-title":"Seroprevalence of Anti-SARS-CoV-2 IgG Antibodies in Juba, South Sudan: A Population-Based Study","volume":"27","author":"Wiens","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/S1473-3099(20)30858-6","article-title":"SARS-CoV-2 antibody seroprevalence in the general population and high-risk occupational groups across 18 cities in Iran: A population-based cross-sectional study","volume":"21","author":"Poustchi","year":"2020","journal-title":"Lancet Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e773","DOI":"10.1016\/S2214-109X(21)00053-X","article-title":"Prevalence of SARS-CoV-2 in six districts in Zambia in July, 2020: A cross-sectional cluster sample survey","volume":"9","author":"Mulenga","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1093\/cid\/ciab515","article-title":"High Prevalence of Anti\u2013Severe Acute Respiratory Syndrome Coronavirus 2 (Anti\u2013SARS-CoV-2) Antibodies After the First Wave of Coronavirus Disease 2019 (COVID-19) in Kinshasa, Democratic Republic of the Congo: Results of a Cross-sectional Household-Based Survey","volume":"74","author":"Nkuba","year":"2021","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"n334","DOI":"10.1136\/bmj.n334","article-title":"Covid-19 deaths in Africa: Prospective systematic postmortem surveillance study","volume":"372","author":"Mwananyanda","year":"2021","journal-title":"BMJ"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1136\/thoraxjnl-2020-215091","article-title":"COVID-19: In the footsteps of Ernest Shackleton","volume":"75","author":"Ing","year":"2020","journal-title":"Thorax"},{"key":"ref_33","first-page":"1","article-title":"High seroprevalence of COVID-19 infection in a large slum in South India; what does it tell us about managing a pandemic and beyond?","volume":"149","author":"George","year":"2021","journal-title":"Epidemiol. Infect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"625","DOI":"10.4269\/ajtmh.20-0564","article-title":"Review of Burden, Clinical Definitions, and Management of COVID-19 Cases","volume":"103","author":"McArthur","year":"2020","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Byambasuren, O., Dobler, C.C., Bell, K., Rojas, D.P., Clark, J., McLaws, M.-L., and Glasziou, P. (2021). Comparison of seroprevalence of SARS-CoV-2 infections with cumulative and imputed COVID-19 cases: Systematic review. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0248946"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0140-6736(22)00100-3","article-title":"COVID-19 will continue but the end of the pandemic is near","volume":"399","author":"Murray","year":"2022","journal-title":"Lancet"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Mossong, J., Hens, N., Jit, M., Beutels, P., Auranen, K., Mikolajczyk, R., Massari, M., Salmaso, S., Tomba, G.S., and Wallinga, J. (2008). Social Contacts and Mixing Patterns Relevant to the Spread of Infectious Diseases. PLoS Med., 5.","DOI":"10.1371\/journal.pmed.0050074"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Rumain, B., Schneiderman, M., and Geliebter, A. (2021). Prevalence of COVID-19 in adolescents and youth compared with older adults in states experiencing surges. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0242587"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1038\/s41590-021-01089-8","article-title":"Children develop robust and sustained cross-reactive spike-specific immune responses to SARS-CoV-2 infection","volume":"23","author":"Dowell","year":"2021","journal-title":"Nat. Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"636","DOI":"10.3201\/eid2702.201960","article-title":"Seroprevalence of SARS-CoV-2 in Guilan Province, Iran, April 2020","volume":"27","author":"Shakiba","year":"2021","journal-title":"Emerg. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S0140-6736(20)31304-0","article-title":"Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland (SEROCoV-POP): A population-based study","volume":"396","author":"Stringhini","year":"2020","journal-title":"Lancet"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/S0140-6736(20)31483-5","article-title":"Prevalence of SARS-CoV-2 in Spain (ENE-COVID): A nationwide, population-based seroepidemiological study","volume":"396","author":"Oteo","year":"2020","journal-title":"Lancet"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.ijid.2021.05.040","article-title":"SARS-CoV-2 seroprevalence among the general population and healthcare workers in India, December 2020\u2013January 2021","volume":"108","author":"Murhekar","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2101040","DOI":"10.2807\/1560-7917.ES.2021.26.48.2101040","article-title":"Under-diagnosis of SARS-CoV-2 infections among children aged 0\u201315 years, a nationwide seroprevalence study, Israel, January 2020 to March 2021","volume":"26","author":"Indenbaum","year":"2021","journal-title":"Eurosurveillance"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"n616","DOI":"10.1136\/bmj.n616","article-title":"Clustering and longitudinal change in SARS-CoV-2 seroprevalence in school children in the canton of Zurich, Switzerland: Prospective cohort study of 55 schools","volume":"372","author":"Ulyte","year":"2021","journal-title":"BMJ"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2101098","DOI":"10.2807\/1560-7917.ES.2021.26.50.2101098","article-title":"Study group members COVID-19 trends and severity among symptomatic children aged 0\u201317 years in 10 European Union countries, 3 August 2020 to 3 October 2021","volume":"26","author":"Bundle","year":"2021","journal-title":"Eurosurveillance"},{"key":"ref_47","unstructured":"Cloete, J., Kruger, A., Masha, M., Plessis, N.M.D., Mawela, D., Tshukudu, M., Manyane, T., Komane, L., Venter, M., and Jassat, W. (2022, January 15). Rapid Rise in Paediatric COVID-19 Hospitalisations during the Early Stages of the Omicron Wave, Tshwane District, South Africa [Preprint]. Available online: https:\/\/www.medrxiv.org\/content\/10.1101\/2021.12.21.21268108v1#:~:text=Background%20South%20Africa%20reported%20a,COVID%2D19%2Dassociated%20hospitalisations."},{"key":"ref_48","unstructured":"World Health Organization (2022, January 23). COVID-19 Disease in Children and Adolescents: Scientific Brief, 29 September 2021. Available online: https:\/\/www.who.int\/publications-detail-redirect\/WHO-2019-nCoV-Sci_Brief-Children_and_adolescents-2021.1."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Bobrovitz, N., Arora, R.K., Cao, C., Boucher, E., Liu, M., Donnici, C., Yanes-Lane, M., Whelan, M., Perlman-Arrow, S., and Chen, J. (2021). Global seroprevalence of SARS-CoV-2 antibodies: A systematic review and meta-analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0252617"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e1390","DOI":"10.1016\/S2214-109X(20)30387-9","article-title":"SARS-CoV-2 antibody prevalence in Brazil: Results from two successive nationwide serological household surveys","volume":"8","author":"Hallal","year":"2020","journal-title":"Lancet Glob. Health"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Tuells, J., Egoavil, C.M., Pena Pardo, M.A., Montagud, A.C., Montagud, E., Caballero, P., Zapater, P., Puig-Barber\u00e1, J., and Hurtado-Sanchez, J.A. (2021). Seroprevalence Study and Cross-Sectional Survey on COVID-19 for a Plan to Reopen the University of Alicante (Spain). Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18041908"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1093\/ntr\/ntab004","article-title":"Impact of Tobacco Smoking on the Risk of COVID-19: A Large Scale Retrospective Cohort Study","volume":"23","author":"Paleiron","year":"2021","journal-title":"Nicotine Tob. Res. Off. J. Soc. Res. Nicotine Tob."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"33","DOI":"10.5802\/crbiol.8","article-title":"A nicotinic hypothesis for Covid-19 with preventive and therapeutic implications","volume":"343","author":"Changeux","year":"2020","journal-title":"Comptes Rendus. Biol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1136\/thoraxjnl-2021-217080","article-title":"Smoking and COVID-19 outcomes: An observational and Mendelian randomisation study using the UK Biobank cohort","volume":"77","author":"Clift","year":"2021","journal-title":"Thorax"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-021-11579-x","article-title":"Smoking is associated with worse outcomes of COVID-19 particularly among younger adults: A systematic review and meta-analysis","volume":"21","author":"Patanavanich","year":"2021","journal-title":"BMC Public Health"},{"key":"ref_56","unstructured":"(2022, January 19). Tude ComCor sur Les Lieux de Contamination au SARS-CoV-2: O\u00f9 Les Fran\u00e7ais S\u2019infectent-Ils?. Available online: https:\/\/www.pasteur.fr\/fr\/espace-presse\/documents-presse\/etude-comcor-lieux-contamination-au-sars-cov-2-ou-francais-s-infectent-ils."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"jiaa273","DOI":"10.1093\/infdis\/jiaa273","article-title":"Sensitivity in Detection of Antibodies to Nucleocapsid and Spike Proteins of Severe Acute Respiratory Syndrome Coronavirus 2 in Patients With Coronavirus Disease 2019","volume":"222","author":"Burbelo","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"103561","DOI":"10.1016\/j.ebiom.2021.103561","article-title":"Evolution of antibody responses up to 13 months after SARS-CoV-2 infection and risk of reinfection","volume":"71","author":"Gallais","year":"2021","journal-title":"EBioMedicine"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"103419","DOI":"10.1016\/j.ebiom.2021.103419","article-title":"SARS-CoV-2 antibody seroprevalence follow-up in Malagasy blood donors during the 2020 COVID-19 Epidemic","volume":"68","author":"Schoenhals","year":"2021","journal-title":"EBioMedicine"},{"key":"ref_60","unstructured":"Centers for Disease Control and Prevention (2022, January 22). Science Brief: SARS-CoV-2 Infection-Induced and Vaccine-Induced Immunity, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/science\/science-briefs\/vaccine-induced-immunity.html."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/4\/971\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:52:53Z","timestamp":1760136773000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/4\/971"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,13]]},"references-count":60,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["diagnostics12040971"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12040971","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-1317280\/v1","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-1317280\/v2","asserted-by":"object"}]},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,13]]}}}