tetano
Editor, Senior Moderator
JAMA Netw Open
. 2021 Feb 1;4(2):e2035234.
doi: 10.1001/jamanetworkopen.2020.35234.
Assessment of Seroprevalence of SARS-CoV-2 and Risk Factors Associated With COVID-19 Infection Among Outpatients in Virginia
Elizabeth T Rogawski McQuade[SUP] 1 2 [/SUP], Kristin A Guertin[SUP] 2 [/SUP], Lea Becker[SUP] 1 [/SUP], Darwin Operario[SUP] 1 [/SUP], Jean Gratz[SUP] 1 [/SUP], Dave Guan[SUP] 3 [/SUP], Fauzia Khan[SUP] 3 [/SUP], Jennifer White[SUP] 1 [/SUP], Timothy L McMurry[SUP] 2 [/SUP], Bhruga Shah[SUP] 4 [/SUP], Stephanie Garofalo[SUP] 4 [/SUP], Matt Southerland[SUP] 4 [/SUP], Kelly Bear[SUP] 4 [/SUP], John Brush[SUP] 5 [/SUP], Cynthia Allen[SUP] 5 [/SUP], Amy Frayser[SUP] 6 [/SUP], Rebecca Vokes[SUP] 6 [/SUP], Rashmi Pershad[SUP] 6 [/SUP], Lilian Peake[SUP] 7 [/SUP], Christopher deFilippi[SUP] 4 [/SUP], Kathleen Barackman[SUP] 5 [/SUP], Gonzalo Bearman[SUP] 6 [/SUP], Andrea Bidanset[SUP] 8 [/SUP], Francis Farrell[SUP] 8 [/SUP], David Trump[SUP] 7 [/SUP], Eric R Houpt[SUP] 1 [/SUP]
Affiliations
Abstract
Importance: Data from seroepidemiologic surveys measuring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure in diverse communities and ascertaining risk factors associated with infection are important to guide future prevention strategies.
Objective: To assess the prevalence of previous SARS-CoV-2 infection across Virginia and the risk factors associated with infection after the first wave of coronavirus disease 2019 (COVID-19) infections in the US.
Design, setting, and participants: In this statewide cross-sectional surveillance study, 4675 adult outpatients presenting for health care not associated with COVID-19 in Virginia between June 1 and August 14, 2020, were recruited to participate in a questionnaire and receive venipuncture to assess SARS-CoV-2 serology. Eligibility was stratified to meet age, race, and ethnicity quotas that matched regional demographic profiles.
Main outcomes and measures: The main outcome was SARS-CoV-2 seropositivity, as measured by the Abbott SARS-CoV-2 immunoglobulin G assay.
Results: Among 4675 adult outpatients (mean [SD] age, 48.8 [16.9] years; 3119 women [66.7%]; 3098 White [66.3%] and 4279 non-Hispanic [91.5%] individuals) presenting for non-COVID-19-associated health care across Virginia, the weighted seroprevalence was 2.4% (95% CI, 1.8%-3.1%) and ranged from 0% to 20% by zip code. Seroprevalence was notably higher among participants who were Hispanic (10.2%; 95% CI, 6.1%-14.3%), residing in the northern region (4.4%; 95% CI, 2.8%-6.1%), aged 40 to 49 years (4.4%; 95% CI, 1.8%-7.1%), and uninsured (5.9%; 95% CI, 1.5%-10.3%). Higher seroprevalence was associated with Hispanic ethnicity (adjusted odds ratio [aOR], 3.56; 95% CI, 1.76-7.21), residence in a multifamily unit (aOR, 2.55; 95% CI, 1.25-5.22), and contact with an individual with confirmed COVID-19 infection (aOR, 4.33; 95% CI, 1.77-10.58). The sensitivity of serology results was 94% (95% CI, 70%-100%) among those who reported receiving a previous polymerase chain reaction test for COVID-19 infection. Among 101 participants with seropositive results, 67 individuals (66.3%) were estimated to have asymptomatic infection. These data suggested a total estimated COVID-19 burden that was 2.8-fold higher than that ascertained by PCR-positive case counts.
Conclusions and relevance: This large statewide serologic study estimated that 2.4% of adults in Virginia had exposure to SARS-CoV-2, which was 2.8-fold higher than confirmed case counts. Hispanic ethnicity, residence in a multifamily unit, and contact with an individual with confirmed COVID-19 infection were significant risk factors associated with exposure. Most infections were asymptomatic. As of August 2020, the population in Virginia remained largely immunologically naive to the virus.
. 2021 Feb 1;4(2):e2035234.
doi: 10.1001/jamanetworkopen.2020.35234.
Assessment of Seroprevalence of SARS-CoV-2 and Risk Factors Associated With COVID-19 Infection Among Outpatients in Virginia
Elizabeth T Rogawski McQuade[SUP] 1 2 [/SUP], Kristin A Guertin[SUP] 2 [/SUP], Lea Becker[SUP] 1 [/SUP], Darwin Operario[SUP] 1 [/SUP], Jean Gratz[SUP] 1 [/SUP], Dave Guan[SUP] 3 [/SUP], Fauzia Khan[SUP] 3 [/SUP], Jennifer White[SUP] 1 [/SUP], Timothy L McMurry[SUP] 2 [/SUP], Bhruga Shah[SUP] 4 [/SUP], Stephanie Garofalo[SUP] 4 [/SUP], Matt Southerland[SUP] 4 [/SUP], Kelly Bear[SUP] 4 [/SUP], John Brush[SUP] 5 [/SUP], Cynthia Allen[SUP] 5 [/SUP], Amy Frayser[SUP] 6 [/SUP], Rebecca Vokes[SUP] 6 [/SUP], Rashmi Pershad[SUP] 6 [/SUP], Lilian Peake[SUP] 7 [/SUP], Christopher deFilippi[SUP] 4 [/SUP], Kathleen Barackman[SUP] 5 [/SUP], Gonzalo Bearman[SUP] 6 [/SUP], Andrea Bidanset[SUP] 8 [/SUP], Francis Farrell[SUP] 8 [/SUP], David Trump[SUP] 7 [/SUP], Eric R Houpt[SUP] 1 [/SUP]
Affiliations
- PMID: 33555331
- DOI: 10.1001/jamanetworkopen.2020.35234
Abstract
Importance: Data from seroepidemiologic surveys measuring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure in diverse communities and ascertaining risk factors associated with infection are important to guide future prevention strategies.
Objective: To assess the prevalence of previous SARS-CoV-2 infection across Virginia and the risk factors associated with infection after the first wave of coronavirus disease 2019 (COVID-19) infections in the US.
Design, setting, and participants: In this statewide cross-sectional surveillance study, 4675 adult outpatients presenting for health care not associated with COVID-19 in Virginia between June 1 and August 14, 2020, were recruited to participate in a questionnaire and receive venipuncture to assess SARS-CoV-2 serology. Eligibility was stratified to meet age, race, and ethnicity quotas that matched regional demographic profiles.
Main outcomes and measures: The main outcome was SARS-CoV-2 seropositivity, as measured by the Abbott SARS-CoV-2 immunoglobulin G assay.
Results: Among 4675 adult outpatients (mean [SD] age, 48.8 [16.9] years; 3119 women [66.7%]; 3098 White [66.3%] and 4279 non-Hispanic [91.5%] individuals) presenting for non-COVID-19-associated health care across Virginia, the weighted seroprevalence was 2.4% (95% CI, 1.8%-3.1%) and ranged from 0% to 20% by zip code. Seroprevalence was notably higher among participants who were Hispanic (10.2%; 95% CI, 6.1%-14.3%), residing in the northern region (4.4%; 95% CI, 2.8%-6.1%), aged 40 to 49 years (4.4%; 95% CI, 1.8%-7.1%), and uninsured (5.9%; 95% CI, 1.5%-10.3%). Higher seroprevalence was associated with Hispanic ethnicity (adjusted odds ratio [aOR], 3.56; 95% CI, 1.76-7.21), residence in a multifamily unit (aOR, 2.55; 95% CI, 1.25-5.22), and contact with an individual with confirmed COVID-19 infection (aOR, 4.33; 95% CI, 1.77-10.58). The sensitivity of serology results was 94% (95% CI, 70%-100%) among those who reported receiving a previous polymerase chain reaction test for COVID-19 infection. Among 101 participants with seropositive results, 67 individuals (66.3%) were estimated to have asymptomatic infection. These data suggested a total estimated COVID-19 burden that was 2.8-fold higher than that ascertained by PCR-positive case counts.
Conclusions and relevance: This large statewide serologic study estimated that 2.4% of adults in Virginia had exposure to SARS-CoV-2, which was 2.8-fold higher than confirmed case counts. Hispanic ethnicity, residence in a multifamily unit, and contact with an individual with confirmed COVID-19 infection were significant risk factors associated with exposure. Most infections were asymptomatic. As of August 2020, the population in Virginia remained largely immunologically naive to the virus.