Seroprevalence surveys may be sometimes biased. These caveats mostly include a highly variable degree of seroconversion, with up to one-third asymptomatic subjects who may actually fail to mount a detectable humoral response, a gradual and linearly time-dependent reduction of anti-SARS-CoV-2 antibody titer, which seems to begin already 2 months after the initial molecular diagnosis, as well as an extremely variable diagnostic sensitivity of anti-SARS-CoV-2 antibody testing. These three combined aspects may lead to conclude that serologic evidence of previous SARS-CoV-2 infection may sometimes be unreliable, so that the infection rate based on seroprevalence surveys may underestimate the prevalence of real spread of SARS-CoV-2 infection.
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