Assessment of Seroprevalence of SARS-CoV-2 and Risk Factors Associated With COVID-19 Infection Among Outpatients in Virginia

McQuade, Elizabeth T Rogawski; Guertin, Kristin A.; Becker, Lea; Operario, Darwin J.; Gratz, Jean; Guan, Dave; Khan, Fauzia Anis; White, Jennifer L.; McMurry, Timothy L.; Shah, Bhruga; Garofalo, Stephanie; Southerland, Matt; Bear, Kelly A.; Brush, John E.; Allen, Cynthia M.; Frayser, Amy; Vokes, Rebecca A.; Pershad, Rashmi; Peake, Lilian; deFilippi, Christopher R.; Barackman, Kathleen; Bearman, Gonzalo; Bidanset, Andrea; Farrell, Francis X.; Trump, David H.; Houpt, Eric R.

doi:10.1001/jamanetworkopen.2020.35234

Cited by 47 publications

(59 citation statements)

References 12 publications

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“…Namely, contact with SARS-CoV-2 infected individuals, age over 65 years, non-compliance with epidemiological recommendations, travelling abroad, and having an occupation involving constant contact with people (i.e., physicians and nurses), are linked with higher seroprevalence. Our data confirmed previously published results [ 19 , 25 ].…”

Section: Discussionsupporting

confidence: 94%

“…Poznan is one of the biggest cities in Poland with almost one million inhabitants and, therefore, may represent the situation in other large Polish metropolitan areas, which, in total, represent approximately 30% of the society. However, it should be noted that the seroprevalence can differ in smaller cities and villages, due to, among other factors, the lower access to the health care system and diagnostic centers, as shown by others [ 19 , 20 ]. Based on our results of anti-SARS-CoV-2 seroprevalence, i.e., 0.93%, and demographic data, i.e., data on 3.5 million citizens as well as the numbers of confirmed SARS-CoV-2 infections presented by the Polish Ministry of Health, we calculated that in September 2020, just before the so-called second wave of the pandemic, approximately four-fold more infections occurred than were reported by the government, i.e., 32,550 SARS-CoV-2 infections based on seroprevalence vs. 7985 COVID-19 cases from official statistics.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Anti-SARS-CoV-2 Antibodies in Poznań, Poland, after the First Wave of the COVID-19 Pandemic

et al. 2021

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In comparison to other European countries, during the first months of the COVID-19 pandemic, Poland reported a relatively low number of confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. To estimate the scale of the pandemic in Poland, a serosurvey of antibodies against SARS-CoV-2 was performed after the first wave of COVID-19 in Europe (March–May 2020). Within this study, we collected samples from 28 July to 24 September 2020 and, based on the ELISA results, we found that 1.67% (25/1500, 95% CI 1.13–2.45) of the Poznan (Poland) metropolitan area’s population had antibodies against SARS-CoV-2 after the first wave of COVID-19. However, the presence of anti-SARS-CoV-2 IgG antibodies was confirmed with immunoblotting in 56% (14/25) samples, which finally resulted in a decrease in seroprevalence, i.e., 0.93% (14/1500, 95% CI 0.56–1.56). The positive anti-SARS-CoV-2 IgG results were associated with age, occupation involving constant contact with people, travelling abroad, non-compliance with epidemiological recommendations and direct contact with the novel coronavirus. Our findings confirm the low SARS-CoV-2 incidence in Poland and imply that the population had little herd immunity heading into the second and third wave of the pandemic, and therefore, that herd immunity contributed little to preventing the high numbers of SARS-CoV-2 infections and COVID-19-related deaths in Poland during these subsequent waves.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Prevalence of Anti-SARS-CoV-2 Antibodies in Poznań, Poland, after the First Wave of the COVID-19 Pandemic

et al. 2021

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“…Similar to the HCW cohort, prospective asymptomatic participants without a known COVID-19 diagnosis residing in the community were enrolled as part of the public health surveillance program in Virginia from June 1 to August 14, 2020 from 5 geographically diverse health system sites: the University of Virginia Health System, Inova Health System, Sentara, Healthcare, Carilion Clinic, and Virginia Commonwealth University [8] . Selection of the sites was based on geographically diverse health system sites from Northern, Eastern, and Western regions of the state of Virginia.…”

Section: Methodsmentioning

confidence: 99%

“…All community participants had to go to one ambulatory clinic for testing. All adult outpatient participants presented in person for scheduled outpatient clinic or outpatient laboratory appointment were eligible to be enrolled in the community study [8] . All outpatient sites conducted pre-screening to ensure that participants did not have COVID-19 like symptoms prior to enrolment in the study.…”

Section: Methodsmentioning

confidence: 99%

“…Participants were included in this analysis if they were adults >18 years of age, resided in the Northern Virginia region willing to sign an informed consent to participate in the study. The community participants were evaluated in a state wide cross-sectional surveillance program [8] . The use of community population was generalizable since it had demographics that matched the region and drew on multiple ambulatory clinics from a variety of different socio-economic districts within Northern Virginia.This protocol was approved by the University of Virginia institutional review board with a waiver of informed consent because the study was requested by the Virginia Department of Health as a public health surveillance according to 45 CFR §46.102.…”

Section: Methodsmentioning

confidence: 99%

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Seropositivity of COVID-19 among asymptomatic healthcare workers: A multi-site prospective cohort study from Northern Virginia, United States

Damluji

Wei

Bruce

et al. 2021

The Lancet Regional Health - Americas

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Background Because of their direct patient contact, healthcare workers (HCW) face an unprecedented risk of exposure to COVID-19. The aim of this study was to examine incidence of COVID-19 disease among asymptomatic HCW and community participants in Northern Virginia during 6 months of follow-up. Methods This is a prospective cohort study that enrolled healthy HCW and residents who never had a symptomatic COVID-19 infection prior to enrolment from the community in Northern Virginia from April to November 2020. All participants were invited to enrol in study, and they were followed at 2-, and 6-months intervals. Participants were evaluated by commercial chemiluminescence SARS-CoV-2 serology assays as part of regional health system and public health surveillance program to monitor the spread of COVID-19 disease. Findings Of a total of 1,819 asymptomatic HCW enrolled, 1,473 (96%) had data at two-months interval, and 1,323 (73%) participants had data at 6-months interval. At baseline, 21 (1.15%) were found to have prior COVID-19 exposure. At two-months interval, COVID-19 rate was 2.8% and at six months follow-up, the overall incidence rate increased to 4.8%, but was as high as 7.9% among those who belong to the youngest age group (20–29 years). Seroconversion rates in HCW were comparable to the seropositive rates in the Northern Virginia community. The overall incidence of COVID-19 in the community was 4.5%, but the estimate was higher among Hispanic ethnicity (incidence rate = 15.3%) potentially reflecting different socio-economic factors among the community participants and the HCW group. Using cross-sectional logistic regression and spatio-temporal mixed effects models, significant factors that influence the transmission rate among HCW include age, race/ethnicity, resident ZIP-code, and household exposure, but not direct patient contact. Interpretation In Northern Virginia, the seropositive rate of COVID-19 disease among HCW was comparable to that in the community.

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Awareness of SARS-CoV-2 Omicron Variant Infection Among Adults With Recent COVID-19 Seropositivity

et al. 2022

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ImportanceSome individuals who were infected by the SARS-CoV-2 Omicron variant may have been completely unaware of their infectious status while the virus was actively transmissible.ObjectiveTo examine awareness of infectious status among individuals during the recent Omicron variant surge in a diverse and populous urban region of Los Angeles County.Design, Setting, and ParticipantsThis cohort study analyzed the records of adult employees and patients of an academic medical center who were enrolled in a longitudinal COVID-19 serological study in Los Angeles County, California. These participants had 2 or more serial anti-nucleocapsid IgG (IgG-N) antibody measurements at least 1 month apart, with the first occurring after the end of a regional Delta variant surge (September 15, 2021) and a subsequent one occurring after the start of a regional Omicron variant surge (December 15, 2021). Adults with evidence of new SARS-CoV-2 infection occurring during the Omicron variant surge period through May 4, 2022, were included in the present study sample.ExposuresRecent Omicron variant infection as evidenced by SARS-CoV-2 seroconversion.Main Outcomes and MeasuresAwareness of recent SARS-CoV-2 infection was ascertained from review of self-reported health updates, medical records, and COVID-19 testing data.ResultsOf the 210 participants (median [range] age, 51 (23-84) years; 136 women [65%]) with serological evidence of recent Omicron variant infection, 44% (92) demonstrated awareness of any recent Omicron variant infection and 56% (118) reported being unaware of their infectious status. Among those who were unaware, 10% (12 of 118) reported having had any symptoms, which they attributed to a common cold or other non–SARS-CoV-2 infection. In multivariable analyses that accounted for demographic and clinical characteristics, participants who were health care employees of the medical center were more likely than nonemployees to be aware of their recent Omicron variant infection (adjusted odds ratio, 2.46; 95% CI, 1.30-4.65).Conclusions and RelevanceResults of this study suggest that more than half of adults with recent Omicron variant infection were unaware of their infectious status and that awareness was higher among health care employees than nonemployees, yet still low overall. Unawareness may be a highly prevalent factor associated with rapid person-to-person transmission within communities.

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Assessment of Seroprevalence of SARS-CoV-2 and Risk Factors Associated With COVID-19 Infection Among Outpatients in Virginia

Cited by 47 publications

References 12 publications

Prevalence of Anti-SARS-CoV-2 Antibodies in Poznań, Poland, after the First Wave of the COVID-19 Pandemic

Prevalence of Anti-SARS-CoV-2 Antibodies in Poznań, Poland, after the First Wave of the COVID-19 Pandemic

Seropositivity of COVID-19 among asymptomatic healthcare workers: A multi-site prospective cohort study from Northern Virginia, United States

Awareness of SARS-CoV-2 Omicron Variant Infection Among Adults With Recent COVID-19 Seropositivity

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