The Lancet: First nationally representative estimate of COVID-19 seroprevalence in the U.S. suggests few in the population developed antibodies in the first wavehttps://www.eurekalert.org/pub_releases/2020-09/tl-pss_1092420.phphttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32009-2/fulltextNation-wide cross-sectional analysis of U.S. patients receiving dialysis finds fewer than 10% of people had COVID-19 antibodies by July 2020, and fewer than 10% of those with antibodies had been diagnosed by antigen or PCR testing. *
Researchers say this representative population is ideal for studying the general spread of COVID-19 in the U.S. because these patients undergo monthly, routine blood draws and represent other similar COVID-19 risk factors such as age, non-white race, and poverty. * COVID-19 control efforts should prioritize minorities and people living in densely populated areas to prevent general community spread.
The first cross-sectional, nation-wide analysis of more than 28,000 patients on dialysis in the U.S. found that fewer than 10% of U.S. adults had COVID-19 antibodies as of July 2020 and fewer than 10% were diagnosed. Published today in The Lancet, the new study also shows higher COVID-19 infection rates among ethnic minorities and people living in lower-income, high density, urban areas - underling the need for COVID-19 public health efforts that prioritize these populations in order to prevent general community spread.
Researchers from Stanford University explain that patients on dialysis represent an important population to study general COVID-19 seroprevalence. These patients already undergo routine, monthly laboratory studies and represent similar risk factors to contracting COVID-19 as the general population, including age, non-white race, and poverty. Unlike community-based surveys, where a select group may show up for or agree to be tested and require a significant on-the-ground effort to launch, patients on dialysis are amenable to random sampling as part of their routine care.
The study follows previous findings from recent seroprevalence studies of highly affected countries and regions (e.g. Wuhan, China, and Spain), which have shown that despite the intense strain on resources and unprecedented excess mortality, rates of seroprevalence at the population level remain low. Other seroprevalence studies of the U.S. population have been restricted to regional hotspots, such as New York City.
... Findings showed that, compared to the majority non-Hispanic white population, people living in predominantly Black and Hispanic neighborhoods experienced a two- to four-times higher likelihood of COVID-19 infection (rates of COVID-19 infection were 11.3% to 16.3% in Black and Hispanic neighborhoods, compared to 4.8% in the majority non-Hispanic white population) while poorer areas experienced a two-times higher likelihood, and the most densely populated areas showed a 10-times higher likelihood of SARS-CoV-2 seropositivity.
In the study, researchers tested the seroprevalence of SARS-CoV-2 antibodies in a randomly selected representative sample of 28,503 patients to provide a nationwide estimate of exposure to SARS-CoV-2 during the first wave of the pandemic. ... Accounting for the externally validated test sensitivity, seroprevalence ranged from 8.2% to 9.4% in the sampled population. Researchers estimated the SARS-CoV-2 standardized seroprevalence in the U.S. population to be approximately 9.3%. The authors also found significant regional variation from less than 5% in the western United States to greater than 25% in the northeast.
"This research clearly confirms that despite high rates of COVID-19 in the United States, the number of people with antibodies is still low and we haven't come close to achieving herd immunity. Until an effective vaccine is approved, we need to make sure our more vulnerable populations are reached with prevention measures," said study author Julie Parsonnet, MD, a Professor of Medicine at Stanford University.
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