The decline in heart transplantation in the UK
Authors: G. A. MacGowan, G. Parry, S. Schueler, A. Hasan
Journal: BMJ (2011)

<h3>Abstract</h3> <h3>Background</h3> Coronavirus disease 2019 (COVID-19) has emerged as a pandemic, and the infection due to SARSCoV-2 has now spread to more than 200 countries<sup>3</sup>. Surveillance systems form the foundation stone of active case finding, testing and contact tracing, which are the key components of the public health response to this novel, emerging infectious disease<sup>4</sup>. There is uncertainty about the true proportion of patients who remain asymptomatic or pre-symptomatic at a given time. As per the WHO-China Joint Monitoring Mission Report, and an analysis of 21 published reports, anywhere between 5 and 80 per cent of SARS-CoV-2-infected patients have been noted to be asymptomatic<sup>5, 6</sup> Whereas in India 4197563 cases are positive, in which in West Bengal total 180788 cases(4.04% of Cases of India) positive of COVID 19. In Paschim Medinipur (West Medinipur) district contributing total 5489 cases (3.03% cases of West Bengal)<sup>9,10,11</sup>. In this scenario, we want to know the status of IgG seroprevalence of SARS-CoV-2 among asymptomatic general population, so that we can determine the extent of infection of SARS-CoV-2 in general population. <h3>Objectives</h3> Primary Objective:- To estimate the seroprevalence for SARS-CoV-2 infection in the general asymptomatic population at Paschim Medinipur District. Secondary Objectives-To estimate age and sex specific seroprevalence. To determine the socio demographic risk factors for SARS-CoV-2 infection; To determine the other risk factors like comorbidities, vaccination status, travel history, contact history etc.; To determine the durability of Immunity (IgG) conferred by natural infection of SARS-CoV-2 in individuals previously RTPCR positive. <h3>Methodology</h3> It was a cross sectional 30 cluster study among the population of Paschim Medinipur district of West Bengal conducted in last week of July and 1<sup>st</sup> week of August 2020 among 458 asymptomatic general population and 30 RTPCR positive cases in 30 villages or wards of municipalities. 30 clusters were chosen from list of COVID 19 affected villages/wards of municipality as per PPS (Probability Proportional to Size) method. <h3>Results</h3> Of the 458 asymptomatic general population,19 asymptomatic people found to be seropositive IgG for SARS-CoV-2 with Mean or average total seropositivity rate of 4.15%. 19 Out of 30 (63.33%) RTPCR positive patients found Seronegative. Median of Days between RTPCR test and sero negativity found was 60 with minimum 28 days to maximum 101 days and Range of 73 days and a standard deviation of 19.46. Among risk factors, the risk of having IgG is more in persons having Travel history with odds ratio of 2.99-95%CI (1.17-7.65) with p-value-0.02. Hydroxychloroquine prophylaxis with Odds ratio of 8.49-95% CI(1.59-45.19) with p value - 0.003. Occupation as migrant labour with Odds ratio of 5.08-95% CI(1.96-13.18) with p value of 0.001. H/O Chicken pox with Odds ratio of 2.15-95% CI(0.59-7.79) with p value of 0.017. Influenza vaccinated with Odds ratio of 8.07 with 95% CI (0.8-81.48) with a p value of 0.036. <h3>Conclusion</h3> Of the 458 asymptomatic general population,19 asymptomatic people found to be seropositive IgG for SARS-CoV-2 with Mean or average total seropositivity rate of 4.15%. 19 Out of 30 (63.33%) RTPCR positive patients found Seronegative. Median of Days between RTPCR test and sero negativity found was 60 with minimum 28 days to maximum 101 days and Range of 73 days and a standard deviation of 19.46. Those having Travel History and having occupation as Migrant Labourer – have significantly higher probability of getting infected with SARS-CoV-2. No role has been found of Hydroxychloroquine Medicines as Chemoprophylactic. No durable immunity conferred by natural infection with SARS-CoV-2 –mean time to become seronegative after positive RTPCR test 60 days. So there is a chance of reinfection after average 2 months.