Ethnoracial Disparities in SARS-CoV-2 Seroprevalence in a Large Cohort of Individuals in Central North Carolina from April to December 2020

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Citation

Lopez, Cesar A.; Cunningham, Clark H.; Pugh, Sierra; Brandt, Katerina; Vanna, Usaphea P.; Delacruz, Matthew J.; Guerra, Quique; Bhowmik, D. Ryan; Goldstein, Samuel Jacob; & Hou, Yixuan Jacob, et al. (2022). Ethnoracial Disparities in SARS-CoV-2 Seroprevalence in a Large Cohort of Individuals in Central North Carolina from April to December 2020. mSphere, 7(3), e0084121. PMCID: PMC9241523

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of deaths around the world within the past 2 years. Transmission within the United States has been heterogeneously distributed by geography and social factors with little data from North Carolina. Here, we describe results from a weekly cross-sectional study of 12,471 unique hospital remnant samples from 19 April to 26 December 2020 collected by four clinical sites within the University of North Carolina Health system, with a majority of samples from urban, outpatient populations in central North Carolina. We employed a Bayesian inference model to calculate SARS-CoV-2 spike protein immunoglobulin prevalence estimates and conditional odds ratios for seropositivity. Furthermore, we analyzed a subset of these seropositive samples for neutralizing antibodies. We observed an increase in seroprevalence from 2.9 (95% confidence interval [CI], 1.8 to 4.5) to 12.8 (95% CI, 10.6 to 15.2) over the course of the study. Latinx individuals had the highest odds ratio of SARS-CoV-2 exposure at 6.56 (95% CI, 4.66 to 9.44). Our findings aid in quantifying the degree of asymmetric SARS-CoV-2 exposure by ethnoracial grouping. We also find that 49% of a subset of seropositive individuals had detectable neutralizing antibodies, which was skewed toward those with recent respiratory infection symptoms.
IMPORTANCE: PCR-confirmed SARS-CoV-2 cases underestimate true prevalence. Few robust community-level SARS-CoV-2 ethnoracial and overall prevalence estimates have been published for North Carolina in 2020. Mortality has been concentrated among ethnoracial minorities and may result from a high likelihood of SARS-CoV-2 exposure, which we observe was particularly high among Latinx individuals in North Carolina. Additionally, neutralizing antibody titers are a known correlate of protection. Our observation that development of SARS-CoV-2 neutralizing antibodies may be inconsistent and dependent on severity of symptoms makes vaccination a high priority despite prior exposure.

URL

http://dx.doi.org/10.1128/msphere.00841-21

Reference Type

Journal Article

Year Published

2022

Journal Title

mSphere

Author(s)

Lopez, Cesar A.
Cunningham, Clark H.
Pugh, Sierra
Brandt, Katerina
Vanna, Usaphea P.
Delacruz, Matthew J.
Guerra, Quique
Bhowmik, D. Ryan
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.
Baric, Ralph S.
Emch, Michael E.
Boyce, Ross M.
Aiello, Allison E.
Fosdick, Bailey K.
Larremore, Daniel B.
de Silva, Aravinda M.
Juliano, Jonathan J.
Markmann, Alena J.

Article Type

Regular

PMCID

PMC9241523

Continent/Country

United States of America

State

North Carolina

ORCiD

Emch - 0000-0003-2642-965X
Aiello - 0000-0001-7029-2537
Boyce, R - 0000-0002-9489-6324
Brandt - 0000-0003-2529-7720