tetano
Editor, Senior Moderator
mSphere
. 2022 May 19;e0084121.
doi: 10.1128/msphere.00841-21. Online ahead of print.
Ethnoracial Disparities in SARS-CoV-2 Seroprevalence in a Large Cohort of Individuals in Central North Carolina from April to December 2020
Cesar A Lopez[SUP] #[/SUP][SUP] 1 [/SUP], Clark H Cunningham[SUP] #[/SUP][SUP] 2 [/SUP], Sierra Pugh[SUP] 3 [/SUP], Katerina Brandt[SUP] 4 5 [/SUP], Usaphea P Vanna[SUP] 1 [/SUP], Matthew J Delacruz[SUP] 1 [/SUP], Quique Guerra[SUP] 1 [/SUP], D Ryan Bhowmik[SUP] 1 [/SUP], Samuel J Goldstein[SUP] 6 [/SUP], Yixuan J Hou[SUP] 7 [/SUP], Margaret Gearhart[SUP] 8 [/SUP], Christine Wiethorn[SUP] 9 [/SUP], Candace Pope[SUP] 9 [/SUP], Carolyn Amditis[SUP] 10 [/SUP], Kathryn Pruitt[SUP] 11 [/SUP], Cinthia Newberry-Dillon[SUP] 11 [/SUP], John L Schmitz[SUP] 12 [/SUP], Lakshmanane Premkumar[SUP] 1 [/SUP], Adaora A Adimora[SUP] 7 13 [/SUP], Ralph S Baric[SUP] 1 7 [/SUP], Michael Emch[SUP] 4 5 7 [/SUP], Ross M Boyce[SUP] 7 13 [/SUP], Allison E Aiello[SUP] 7 [/SUP], Bailey K Fosdick[SUP] 3 [/SUP], Daniel B Larremore[SUP] 14 15 [/SUP], Aravinda M de Silva[SUP] 1 [/SUP], Jonathan J Juliano[SUP] 7 13 [/SUP], Alena J Markmann[SUP] 13 [/SUP]
Affiliations
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of deaths around the world within the past 2 years. Transmission within the United States has been heterogeneously distributed by geography and social factors with little data from North Carolina. Here, we describe results from a weekly cross-sectional study of 12,471 unique hospital remnant samples from 19 April to 26 December 2020 collected by four clinical sites within the University of North Carolina Health system, with a majority of samples from urban, outpatient populations in central North Carolina. We employed a Bayesian inference model to calculate SARS-CoV-2 spike protein immunoglobulin prevalence estimates and conditional odds ratios for seropositivity. Furthermore, we analyzed a subset of these seropositive samples for neutralizing antibodies. We observed an increase in seroprevalence from 2.9 (95% confidence interval [CI], 1.8 to 4.5) to 12.8 (95% CI, 10.6 to 15.2) over the course of the study. Latinx individuals had the highest odds ratio of SARS-CoV-2 exposure at 6.56 (95% CI, 4.66 to 9.44). Our findings aid in quantifying the degree of asymmetric SARS-CoV-2 exposure by ethnoracial grouping. We also find that 49% of a subset of seropositive individuals had detectable neutralizing antibodies, which was skewed toward those with recent respiratory infection symptoms. IMPORTANCE PCR-confirmed SARS-CoV-2 cases underestimate true prevalence. Few robust community-level SARS-CoV-2 ethnoracial and overall prevalence estimates have been published for North Carolina in 2020. Mortality has been concentrated among ethnoracial minorities and may result from a high likelihood of SARS-CoV-2 exposure, which we observe was particularly high among Latinx individuals in North Carolina. Additionally, neutralizing antibody titers are a known correlate of protection. Our observation that development of SARS-CoV-2 neutralizing antibodies may be inconsistent and dependent on severity of symptoms makes vaccination a high priority despite prior exposure.
Keywords: COVID-19; SARS-CoV-2; health disparities; neutralization; seroprevalence.
. 2022 May 19;e0084121.
doi: 10.1128/msphere.00841-21. Online ahead of print.
Ethnoracial Disparities in SARS-CoV-2 Seroprevalence in a Large Cohort of Individuals in Central North Carolina from April to December 2020
Cesar A Lopez[SUP] #[/SUP][SUP] 1 [/SUP], Clark H Cunningham[SUP] #[/SUP][SUP] 2 [/SUP], Sierra Pugh[SUP] 3 [/SUP], Katerina Brandt[SUP] 4 5 [/SUP], Usaphea P Vanna[SUP] 1 [/SUP], Matthew J Delacruz[SUP] 1 [/SUP], Quique Guerra[SUP] 1 [/SUP], D Ryan Bhowmik[SUP] 1 [/SUP], Samuel J Goldstein[SUP] 6 [/SUP], Yixuan J Hou[SUP] 7 [/SUP], Margaret Gearhart[SUP] 8 [/SUP], Christine Wiethorn[SUP] 9 [/SUP], Candace Pope[SUP] 9 [/SUP], Carolyn Amditis[SUP] 10 [/SUP], Kathryn Pruitt[SUP] 11 [/SUP], Cinthia Newberry-Dillon[SUP] 11 [/SUP], John L Schmitz[SUP] 12 [/SUP], Lakshmanane Premkumar[SUP] 1 [/SUP], Adaora A Adimora[SUP] 7 13 [/SUP], Ralph S Baric[SUP] 1 7 [/SUP], Michael Emch[SUP] 4 5 7 [/SUP], Ross M Boyce[SUP] 7 13 [/SUP], Allison E Aiello[SUP] 7 [/SUP], Bailey K Fosdick[SUP] 3 [/SUP], Daniel B Larremore[SUP] 14 15 [/SUP], Aravinda M de Silva[SUP] 1 [/SUP], Jonathan J Juliano[SUP] 7 13 [/SUP], Alena J Markmann[SUP] 13 [/SUP]
Affiliations
- PMID: 35587682
- DOI: 10.1128/msphere.00841-21
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of deaths around the world within the past 2 years. Transmission within the United States has been heterogeneously distributed by geography and social factors with little data from North Carolina. Here, we describe results from a weekly cross-sectional study of 12,471 unique hospital remnant samples from 19 April to 26 December 2020 collected by four clinical sites within the University of North Carolina Health system, with a majority of samples from urban, outpatient populations in central North Carolina. We employed a Bayesian inference model to calculate SARS-CoV-2 spike protein immunoglobulin prevalence estimates and conditional odds ratios for seropositivity. Furthermore, we analyzed a subset of these seropositive samples for neutralizing antibodies. We observed an increase in seroprevalence from 2.9 (95% confidence interval [CI], 1.8 to 4.5) to 12.8 (95% CI, 10.6 to 15.2) over the course of the study. Latinx individuals had the highest odds ratio of SARS-CoV-2 exposure at 6.56 (95% CI, 4.66 to 9.44). Our findings aid in quantifying the degree of asymmetric SARS-CoV-2 exposure by ethnoracial grouping. We also find that 49% of a subset of seropositive individuals had detectable neutralizing antibodies, which was skewed toward those with recent respiratory infection symptoms. IMPORTANCE PCR-confirmed SARS-CoV-2 cases underestimate true prevalence. Few robust community-level SARS-CoV-2 ethnoracial and overall prevalence estimates have been published for North Carolina in 2020. Mortality has been concentrated among ethnoracial minorities and may result from a high likelihood of SARS-CoV-2 exposure, which we observe was particularly high among Latinx individuals in North Carolina. Additionally, neutralizing antibody titers are a known correlate of protection. Our observation that development of SARS-CoV-2 neutralizing antibodies may be inconsistent and dependent on severity of symptoms makes vaccination a high priority despite prior exposure.
Keywords: COVID-19; SARS-CoV-2; health disparities; neutralization; seroprevalence.