Risk factors and titers of COVID-19 infection in a longitudinal statewide seroepidemiology cohort

BMC Infectious Diseases

Research

Danielle Guilliams¹  Francis Farrell¹  Andrea B. Mohr¹  Lea Becker²  Suzanne E. Stroup²  Eric R. Houpt²  Elizabeth T. Rogawski McQuade³  Gonzalo Bearman⁴  Rebecca Mullin⁴  Christopher deFilippi⁵  Bhruga Shah⁵  Gay Goldsmith⁶  John Brush⁶  Kathleen Barackman⁶  Fauzia Khan⁷  Lilian Peake⁸ 

[1] Carilion Clinic, Roanoke, VA, USA;Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA;Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA;Department of Epidemiology, Emory University, Atlanta, GA, USA;Division of Infectious Diseases, Virginia Commonwealth University, Richmond, VA, USA;Inova Heart and Vascular Institute, Inova Health System, Falls Church, VA, USA;Office of Clinical Research, Sentara Healthcare, Norfolk, VA, USA;Research & Clinical Trial Analytics Team, University of Virginia, Charlottesville, VA, USA;Virginia Department of Health, Richmond, VA, USA;

关键词: COVID-19;    SARS-CoV-2;    Seroepidemiology;    Nucleocapsid;    Spike;    Vaccine;    Risk factors;   

DOI  :  10.1186/s12879-023-08670-6

 received in 2022-11-23, accepted in 2023-10-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundVirginia is a large state in the USA, yet it remains unclear what percentage of the population has had natural COVID-19 infection and whether risk factors for infection have changed over time.MethodsUsing a longitudinal cohort, from December 2021-July 2022 we performed follow up serology and a questionnaire on 784 individuals from across Virginia who had previously participated in a statewide COVID-19 seroepidemiology study in 2020. Children were also invited to participate and an additional 62 children also completed the study. Serology was performed using Roche nucleocapsid and spike serological assays.ResultsThe majority of participants were white (78.6%), over 50 years old (60.9%), and reported having received COVID-19 vaccine (93.4%). 28.6% had evidence of prior COVID-19 infection (nucleocapsid positive). Reweighted by region, age, and sex to match the Virginia census data, the seroprevalence of nucleocapsid antibodies was estimated to be 30.6% (95% CI: 24.7, 36.6). We estimated that 25–53% of COVID-19 infections were asymptomatic. Infection rates were lower in individuals > 60 years old and were higher in Blacks and Hispanics. Infection rates were also higher in those without health insurance, in those with greater numbers of household children, and in those that reported a close contact or having undergone quarantine for COVID-19. Participants from Southwest Virginia had lower seropositivity (16.2%, 95% CI 6.5, 26.0) than other geographic regions. Boosted vaccinees had lower infection rates than non-boosted vaccinees. Frequenting indoor bars was a risk factor for infection, while frequently wearing an N95 mask was protective, though the estimates of association were imprecise. Infection rates were higher in children than adults (56.5% vs. 28.6%). Infection in the parent was a risk factor for child infection. Spike antibody levels declined with time since last vaccination, particularly in those that were vaccinated but not previously infected. Neutralizing antibody positivity was high (97–99%) for wild type, alpha, beta, gamma, delta, and omicron variants. Neutralizing antibody levels were higher in the follow-up survey compared to the first survey in 2020 and among individuals with evidence of natural infection compared to those without.ConclusionsIn this longitudinal statewide cohort we observed a lower-than-expected COVID-19 infection rate as of August 2022. Boosted vaccinees had lower infection rates. Children had higher infection rates and infections tracked within households. Previously identified demographic risk factors for infection tended to persist. Even after the omicron peak, a large number of Virginians remain uninfected with COVID-19, underscoring the need for ongoing vaccination strategies.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 2