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Disparities in SARS-CoV-2 Seroprevalence among Individuals Presenting for Care in Central North Carolina Over a Six-Month Period

Citation

Lopez, Cesar A.; Cunningham, Clark H.; Pugh, Sierra; Brandt, Katerina; Vanna, Usaphea P.; Delacruz, Matthew J.; Guerra, Quique; Goldstein, Samuel Jacob; Hou, Yixuan Jacob; & Gearhart, Margaret, et al. (Preprint). Disparities in SARS-CoV-2 Seroprevalence among Individuals Presenting for Care in Central North Carolina Over a Six-Month Period. medRxiv. PMCID: PMC8010775

Abstract

Background: Robust community-level SARS-CoV-2 prevalence estimates have been difficult to obtain in the American South and outside of major metropolitan areas. Furthermore, though some previous studies have investigated the association of demographic factors such as race with SARS-CoV-2 exposure risk, fewer have correlated exposure risk to surrogates for socioeconomic status such as health insurance coverage.
Methods: We used a highly specific serological assay utilizing the receptor binding domain of the SARS-CoV-2 spike-protein to identify SARS-CoV-2 antibodies in remnant blood samples collected by the University of North Carolina Health system. We estimated the prevalence of SARS-CoV-2 in this cohort with Bayesian regression, as well as the association of critical demographic factors with higher prevalence odds.
Findings: Between April 21st and October 3rd of 2020, a total of 9,624 unique samples were collected from clinical sites in central NC and we observed a seroprevalence increase from 2.9 (1.7, 4.3) to 9.1 (7.2, 11.1) over the study period. Individuals who identified as Latinx were associated with the highest odds ratio of SARS-CoV-2 exposure at 7.77 overall (5.20, 12.10). Increased odds were also observed among Black individuals and individuals without public or private health insurance.
Interpretation: Our data suggests that for this care-accessing cohort, SARS-CoV-2 seroprevalence was significantly higher than cumulative total cases reported for the study geographical area six months into the COVID-19 pandemic in North Carolina. The increased odds of seropositivity by ethnoracial grouping as well as health insurance highlights the urgent and ongoing need to address underlying health and social disparities in these populations.

URL

http://dx.doi.org/10.1101/2021.03.25.21254320

Reference Type

Journal Article

Article Type

Regular

Year Published

Preprint

Journal Title

medRxiv

Author(s)

Lopez, Cesar A.
Cunningham, Clark H.
Pugh, Sierra
Brandt, Katerina
Vanna, Usaphea P.
Delacruz, Matthew J.
Guerra, Quique
Goldstein, Samuel Jacob
Hou, Yixuan Jacob
Gearhart, Margaret
Wiethorn, Christine
Pope, Candace
Amditis, Carolyn
Pruitt, Kathryn
Newberry-Dillon, Cinthia
Schmitz, John L.
Premkumar, Lakshmanane
Adimora, Adaora A.
Emch, Michael
Boyce, Ross M.
Aiello, Allison E.
Fosdick, Bailey K.
Larremore, Daniel B.
de Silva, Aravinda M.
Juliano, Jonathan J.
Markmann, Alena J.

PMCID

PMC8010775

Continent/Country

United States of America

State

North Carolina

Race/Ethnicity

Black
Hispanic/Latinx