ABSTRACT
Background: There have been few estimates of SARS-CoV-2 seroprevalence in rigorously sampled and geographically broad populations that include children, who have accounted for fewer diagnosed COVID-19 cases compared to adults. The COMPASS study assessed cross-sectional, population-based SARS-CoV-2 seroprevalence and PCR positivity among adults and children in 15 US communities. Methods: Time-location sampling was used to recruit adults and children >2 months of age from randomly selected venues in communities near participating research sites. Demographics, history of COVID-19 and willingness (likely, very likely or already received) to receive an approved COVID-19 vaccine were captured via an interviewer-administered questionnaire. Serologic analysis was performed using a SARS-CoV-2 IgG nucleocapsid antibody (Ab) assay (Abbott Diagnostics, Abbott Park, IL). PCR testing was performed on a mid-turbinate swab using an assay approved by the HPTN Laboratory Center. Prevalence estimates were constructed, overall and by age group (<18 y, 18-39 y, 40-59 y, 60+ y), for each community using survey weights that accounted for the sampling design. Results: A total of 22,732 persons were enrolled (median per community 1,246, range 511 to 2,925) from Jan 2021 to Aug 2021;of these, 2,151 (9.5%) were <18 y. Overall, SARS-CoV-2 seroprevalence (Ab+) ranged from 3.8 to 17.3% (median 12.5%) and SARS-CoV-2 PCR positivity ranged from 0 to 1.9% (median 0.7%). About half of Ab+ and half of PCR+ persons reported no prior or recent (within 14 days) COVID-19 symptoms, respectively [median by community 49.7% (IQR 45.8, 63.9) and 53.6% (IQR 44.3, 58.3)]. Most adults (18+ y) (median 77.3% [69.6 to 92.7%]) reported willingness to get a COVID-19 vaccination;willingness was higher among persons aged 60 y+ [median 88.1%, IQR 83.5, 90.6] compared to those aged 18-39 [median 72.5%, IQR 64.1, 79.8] and 40-59 [median 75.6%, IQR 72.5, 78.4]. The combined prevalence of prior (Ab+) or active (PCR+) SARS-CoV-2 infection across all communities ranged from 4.4 to 17.6% (median 12.7%), and was similar for children (median 12.7%, range 4.4 to 19.7%) and adults (median 12.5%, range 4.4% to 17.8%) among communities enrolling > 25 children (Figure). Conclusion: In this population-based survey, evidence of prior and active SARS-CoV-2 infection varied widely by community but, contrasting with earlier reports, not by age. These findings suggest that acquisition of SARS-CoV-2 is similar across all ages.
ABSTRACT
Background: The Coronavirus disease of 2019 (COVID-19) global health crisis caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in unprecedented mortality, impacted society, and strained healthcare systems, yet sufficient data regarding treatment options are lacking. Convalescent plasma, used since 1895 for infectious disease outbreaks, offers promise as a treatment option for COVID-19. Methods: This is a retrospective study of patients diagnosed by a nasopharyngeal swab SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR), who received convalescent plasma between April to June 2020 at two large hospitals in Miami, Florida, as part of the US FDA Expanded Access Program for COVID-19 convalescent plasma (CCP). Results: A total of 23 patients received CCP, 13 (57%) had severe COVID-19 disease, while 8 (35%) had critical or critical with multiorgan dysfunction. Median time of follow up was 26 (range, 7-79) days. Overall, 11 (48%) survived to discharge, 6 (26%) died, while 6 (26%) are currently hospitalized. All deaths reported were due to septic shock from secondary infections. 15 (65%) showed improvement in oxygen requirements 7 days post CCP transfusion. Measured inflammatory markers, c-reactive protein, lactate dehydrogenase, ferritin and d-dimer improved 7 days post transfusion in 13 (57%) patients. No adverse events due to the transfusion were reported. 10 (43.4%) patients had a negative SARS-CoV-2 RT-PCR at a median of 14.5 (range, 4-31) days after receiving convalescent plasma. Conclusion: Administration of convalescent plasma was found to be safe, with favorable outcomes in this small cohort of relatively high acuity patients. Larger studies including control arms are needed to establish the efficacy of convalescent plasma on clinical and virologic outcomes for patients with COVID-19. (Table Presented).