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Undiagnosed SARS-CoV-2 seropositivity during the first 6 months of the COVID-19 pandemic in the United States.
Kalish, Heather; Klumpp-Thomas, Carleen; Hunsberger, Sally; Baus, Holly Ann; Fay, Michael P; Siripong, Nalyn; Wang, Jing; Hicks, Jennifer; Mehalko, Jennifer; Travers, Jameson; Drew, Matthew; Pauly, Kyle; Spathies, Jacquelyn; Ngo, Tran; Adusei, Kenneth M; Karkanitsa, Maria; Croker, Jennifer A; Li, Yan; Graubard, Barry I; Czajkowski, Lindsay; Belliveau, Olivia; Chairez, Cheryl; Snead, Kelly R; Frank, Peter; Shunmugavel, Anandakumar; Han, Alison; Giurgea, Luca T; Rosas, Luz Angela; Bean, Rachel; Athota, Rani; Cervantes-Medina, Adriana; Gouzoulis, Monica; Heffelfinger, Brittany; Valenti, Shannon; Caldararo, Rocco; Kolberg, Michelle M; Kelly, Andrew; Simon, Reid; Shafiq, Saifullah; Wall, Vanessa; Reed, Susan; Ford, Eric W; Lokwani, Ravi; Denson, John-Paul; Messing, Simon; Michael, Sam G; Gillette, William; Kimberly, Robert P; Reis, Steven E; Hall, Matthew D.
  • Kalish H; Trans-NIH Shared Resource on Biomedical Engineering and Physical Science, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20894, USA.
  • Klumpp-Thomas C; National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850, USA.
  • Hunsberger S; Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Baus HA; Clinical Studies Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Fay MP; Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Siripong N; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA 15213, USA.
  • Wang J; Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA.
  • Hicks J; Trans-NIH Shared Resource on Biomedical Engineering and Physical Science, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20894, USA.
  • Mehalko J; Protein Expression Laboratory, NCI RAS Initiative, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA.
  • Travers J; National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850, USA.
  • Drew M; Protein Expression Laboratory, NCI RAS Initiative, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA.
  • Pauly K; Trans-NIH Shared Resource on Biomedical Engineering and Physical Science, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20894, USA.
  • Spathies J; Trans-NIH Shared Resource on Biomedical Engineering and Physical Science, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20894, USA.
  • Ngo T; Section on Immuno-Engineering, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20894, USA.
  • Adusei KM; Section on Immuno-Engineering, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20894, USA.
  • Karkanitsa M; Section on Immuno-Engineering, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20894, USA.
  • Croker JA; Center for Clinical and Translational Science, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
  • Li Y; Joint Program in Survey Methodology, Department of Epidemiology and Biostatistics, University of Maryland College Park, College Park, MD 20742, USA.
  • Graubard BI; Division of Cancer Epidemiology and Genetics, Biostatistics Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20894, USA.
  • Czajkowski L; Clinical Studies Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Belliveau O; Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Chairez C; Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Snead KR; Protein Expression Laboratory, NCI RAS Initiative, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA.
  • Frank P; Protein Expression Laboratory, NCI RAS Initiative, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA.
  • Shunmugavel A; Section on Immuno-Engineering, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20894, USA.
  • Han A; Clinical Studies Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Giurgea LT; Clinical Studies Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Rosas LA; Clinical Studies Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Bean R; Clinical Studies Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Athota R; Clinical Studies Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Cervantes-Medina A; Clinical Studies Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Gouzoulis M; Clinical Studies Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Heffelfinger B; Clinical Studies Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Valenti S; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA 15213, USA.
  • Caldararo R; Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, MD 21702, USA.
  • Kolberg MM; Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Kelly A; National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850, USA.
  • Simon R; National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850, USA.
  • Shafiq S; National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850, USA.
  • Wall V; Protein Expression Laboratory, NCI RAS Initiative, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA.
  • Reed S; Clinical Studies Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20894, USA.
  • Ford EW; Center for Clinical and Translational Science, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
  • Lokwani R; Section on Immuno-Engineering, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20894, USA.
  • Denson JP; Protein Expression Laboratory, NCI RAS Initiative, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA.
  • Messing S; Protein Expression Laboratory, NCI RAS Initiative, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA.
  • Michael SG; National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850, USA.
  • Gillette W; Protein Expression Laboratory, NCI RAS Initiative, Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA.
  • Kimberly RP; Center for Clinical and Translational Science, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
  • Reis SE; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA 15213, USA.
  • Hall MD; National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD 20850, USA.
Sci Transl Med ; 13(601)2021 07 07.
Article in English | MEDLINE | ID: covidwho-1338832
ABSTRACT
Asymptomatic SARS-CoV-2 infection and delayed implementation of diagnostics have led to poorly defined viral prevalence rates in the United States and elsewhere. To address this, we analyzed seropositivity in 9089 adults in the United States who had not been diagnosed previously with COVID-19. Individuals with characteristics that reflected the U.S. population (n = 27,716) were selected by quota sampling from 462,949 volunteers. Enrolled participants (n = 11,382) provided medical, geographic, demographic, and socioeconomic information and dried blood samples. Survey questions coincident with the Behavioral Risk Factor Surveillance System survey, a large probability-based national survey, were used to adjust for selection bias. Most blood samples (88.7%) were collected between 10 May and 31 July 2020 and were processed using ELISA to measure seropositivity (IgG and IgM antibodies against SARS-CoV-2 spike protein and the spike protein receptor binding domain). The overall weighted undiagnosed seropositivity estimate was 4.6% (95% CI, 2.6 to 6.5%), with race, age, sex, ethnicity, and urban/rural subgroup estimates ranging from 1.1% to 14.2%. The highest seropositivity estimates were in African American participants; younger, female, and Hispanic participants; and residents of urban centers. These data indicate that there were 4.8 undiagnosed SARS-CoV-2 infections for every diagnosed case of COVID-19, and an estimated 16.8 million infections were undiagnosed by mid-July 2020 in the United States.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Female / Humans Country/Region as subject: North America Language: English Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Scitranslmed.abh3826

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Female / Humans Country/Region as subject: North America Language: English Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Scitranslmed.abh3826