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Bonnie Shook-Sa, DrPH, and Alison Aiello, PhD, at the UNC Gillings School of Global Public Health, and Ross Boyce, MD, at the UNC School of Medicine, published a viewpoint piece on the pitfalls of certain types of early SARS-CoV-2 seroprevalence studies.


In the Journal of Infectious Diseases, UNC-Chapel Hill researchers published a viewpoint article titled, “Estimation without Representation: Early SARS-CoV-2 Seroprevalence Studies and the Path Forward.”

The authors are Bonnie Shook-Sa, DrPH, instructor of biostatistics, and Alison Aiello, PhD, professor of epidemiology — both at the UNC Gillings School of Global Public Health — and Ross Boyce, MD, assistant professor of infectious diseases at the UNC School of Medicine.

They write: “The recent development and regulatory approval of a variety of serological assays indicating the presence of antibodies against SARS-CoV-2 has led to rapid and widespread implementation of seroprevalence studies. Accurate estimates of seroprevalence are needed to model transmission dynamics and estimate mortality rates. Furthermore, seroprevalence levels in a population help guide policy surrounding re-opening efforts. The literature to date has focused heavily on issues surrounding the quality of seroprevalence tests and less on the sampling methods which ultimately drive the representativeness of resulting estimates. Seroprevalence studies based on convenience samples are being reported widely and extrapolated to larger populations for the estimation of total COVID-19 infections, comparisons of prevalence across geographic regions, and estimation of mortality rates. In this viewpoint, we discuss the pitfalls that can arise with the use of convenience samples and offer guidance for moving towards more representative and timely population estimates of COVID-19 seroprevalence.”

Boyce is leading a COVID-19 seroprevalence study in Chatham County, North Carolina, and together with Aiello, they are co-leading a network that brings together researchers conducting seroprevalence studies across the state.

Read the full article at the journal website.