Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the cause of coronavirus disease 2019 (COVID-19), has affected millions of people globally. It is a very contagious disease with various clinical manifestations. However, even in asymptomatic patients, it is believed that this virus exposure induces cryptic antibodies as in symptomatic patients. This current study aims to assess the prevalence of SARS-CoV-2 seropositivity by detecting the antibodies specific to the receptor-binding domain (SRBD) of SARS-CoV-2 in the pre-vaccine population in Bali. We assessed specific antibody titers against trimeric spike glycoprotein (S) of SARS-CoV-2 using Roche Elecsys Anti-SARS-CoV-2 S immunoassay in the serum of 510 pre-vaccine subjects without a previous documented history of SARS-CoV-2 infection. The average age was 35.53 years with 56.7% of the subjects being male. Among 510 subjects, 190 (37.3%) subjects were detected to have SARS-CoV-2 SRBD antibody or be seropositive. The range of the antibody titer was zero to 250 U/mL with the average being 44.3 U/mL. The number of subjects who had anti-SARS-Cov-2 SRBD titer above 132 U/mL was 76 (14.9%); it was the minimal antibody titer needed to donate plasma for plasma convalescent therapy. This study revealed a pre-vaccination population, without a history of COVID-19 infection, with seropositivity to SARS-CoV-2, which indicates the underdiagnosis of COVID-19, especially in asymptomatic individuals.
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