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Assessment of Seroprevalence of SARS-CoV-2 and Risk Factors Associated With COVID-19 Infection Among Outpatients in Virginia.
Rogawski McQuade, Elizabeth T; Guertin, Kristin A; Becker, Lea; Operario, Darwin; Gratz, Jean; Guan, Dave; Khan, Fauzia; White, Jennifer; McMurry, Timothy L; Shah, Bhruga; Garofalo, Stephanie; Southerland, Matt; Bear, Kelly; Brush, John; Allen, Cynthia; Frayser, Amy; Vokes, Rebecca; Pershad, Rashmi; Peake, Lilian; deFilippi, Christopher; Barackman, Kathleen; Bearman, Gonzalo; Bidanset, Andrea; Farrell, Francis; Trump, David; Houpt, Eric R.
  • Rogawski McQuade ET; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville.
  • Guertin KA; Department of Public Health Sciences, University of Virginia, Charlottesville.
  • Becker L; Department of Public Health Sciences, University of Virginia, Charlottesville.
  • Operario D; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville.
  • Gratz J; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville.
  • Guan D; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville.
  • Khan F; Research and Clinical Trial Analytics Team, Division of Quality Performance Improvement, University of Virginia, Charlottesville.
  • White J; Research and Clinical Trial Analytics Team, Division of Quality Performance Improvement, University of Virginia, Charlottesville.
  • McMurry TL; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville.
  • Shah B; Department of Public Health Sciences, University of Virginia, Charlottesville.
  • Garofalo S; Inova Heart and Vascular Institute, Inova Health System, Falls Church, Virginia.
  • Southerland M; Inova Heart and Vascular Institute, Inova Health System, Falls Church, Virginia.
  • Bear K; Inova Heart and Vascular Institute, Inova Health System, Falls Church, Virginia.
  • Brush J; Inova Heart and Vascular Institute, Inova Health System, Falls Church, Virginia.
  • Allen C; Office of Clinical Research, Sentara Healthcare, Norfolk, Virginia.
  • Frayser A; Office of Clinical Research, Sentara Healthcare, Norfolk, Virginia.
  • Vokes R; Division of Infectious Diseases, Virginia Commonwealth University, Richmond.
  • Pershad R; Division of Infectious Diseases, Virginia Commonwealth University, Richmond.
  • Peake L; Division of Infectious Diseases, Virginia Commonwealth University, Richmond.
  • deFilippi C; Virginia Department of Health, Richmond.
  • Barackman K; Inova Heart and Vascular Institute, Inova Health System, Falls Church, Virginia.
  • Bearman G; Office of Clinical Research, Sentara Healthcare, Norfolk, Virginia.
  • Bidanset A; Division of Infectious Diseases, Virginia Commonwealth University, Richmond.
  • Farrell F; Carilion Clinic, Roanoke, Virginia.
  • Trump D; Carilion Clinic, Roanoke, Virginia.
  • Houpt ER; Virginia Department of Health, Richmond.
JAMA Netw Open ; 4(2): e2035234, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-1068640
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.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article