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

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

doi:10.1128/msphere.00841-21

mSphere (Jun 2022)

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

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

Affiliations

Cesar A. Lopez: Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
Clark H. Cunningham: Department of Genetics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Sierra Pugh: Department of Statistics, Colorado State University, Fort Collins, Colorado, USA
Katerina Brandt: Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Usaphea P. Vanna: Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
Matthew J. Delacruz: Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
Quique Guerra: Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
D. Ryan Bhowmik: Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
Samuel J. Goldstein: Department of Environmental Sciences and Engineering, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Yixuan J. Hou: Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Margaret Gearhart: McLendon Clinical Laboratories, UNC Healthcare, Chapel Hill, North Carolina, USA
Christine Wiethorn: Johnston Health Laboratories, Johnston Health, Smithfield, North Carolina, USA
Candace Pope: Johnston Health Laboratories, Johnston Health, Smithfield, North Carolina, USA
Carolyn Amditis: Rex Healthcare Laboratory, UNC Healthcare, Raleigh, North Carolina, USA
Kathryn Pruitt: Chatham Clinical Laboratory, Chatham Hospital, Siler City, North Carolina, USA
Cinthia Newberry-Dillon: Chatham Clinical Laboratory, Chatham Hospital, Siler City, North Carolina, USA
John L. Schmitz: Department of Pathology & Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
Lakshmanane Premkumar: Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
Adaora A. Adimora: Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Ralph S. Baric: Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
Michael Emch: Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Ross M. Boyce: Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Allison E. Aiello: Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Bailey K. Fosdick: Department of Statistics, Colorado State University, Fort Collins, Colorado, USA
Daniel B. Larremore: Department of Computer Science, University of Colorado Boulder, Boulder, Colorado, USA
Aravinda M. de Silva: Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
Jonathan J. Juliano: Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Alena J. Markmann: Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA

DOI: https://doi.org/10.1128/msphere.00841-21
Journal volume & issue: Vol. 7, no. 3

Abstract

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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.

Published in mSphere

ISSN: 2379-5042 (Online)
Publisher: American Society for Microbiology
Country of publisher: United States
LCC subjects: Science: Microbiology
Website: https://journals.asm.org/journal/msphere

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