Abstract

Background: SARS- CoV-2 infection have wide range of clinical features ranging from asymptomatic to severe illness with fatal outcomes or recovery. Population-based sero-epidemiological study is one of the most effective method to measure rapid spread of COVID-19 and monitor progression of epidemic. Aim: To undertake repeated cross-sectional serosurvey in rural population of Western India to estimate extent of spread of SARS-CoV-2 infection. Methods: Serosurvey conducted between Jan- Jun 2021 in rural Pune district to assess seroprevalence of SARS-CoV-2. Total 30 clusters selected for each round by proportional random sampling with 30 individuals in each cluster of three age groups (1-17, 18-49, and ?50 years). Blood collected from individuals who consented to participate in study, to detect IgG antibodies against the SARS-CoV-2 in all five rounds. Results: Total 14274 individuals included across five rounds- 29% in 1-17, 39% in 18-49, and 32% in ?50 years. Overall seroprevalence combining all rounds was 45%. Increase in seropositivity in Round 4 (51.1%) and 5 (58.3%) contributed mostly by adults. Factors strongly associated with seropositivity were contacts with suspected or confirmed cases of COVID-19 [7.1 (95% CI 4.2-12.1)]; received at least one dose of COVID-19 vaccine [3.1 ( 0.7-14.1)]; age ?50 years [1.9 (1.8-2.1)]; occupations in high-risk category [1.9 (1.6-2.2)]. Conclusion: Seroprevalence of SARS-CoV-2 was high in last two rounds (Apr-Jun 2021) which coincide with second pandemic wave (variant- Delta [B.1.617.2]) in India. Suspected or confirmed case of COVID-19 emerged as significant factor strongly associated with seropositivity followed by COVID-19 vaccination.