Department of Microbiology and Immunology, University of North Carolina School of Medicinegrid.471389.0, Chapel Hill, North Carolina, USA.
Department of Genetics, School of Medicine, University of North Carolina at Chapel Hillgrid.10698.36, Chapel Hill, North Carolina, USA.
mSphere. 2022 Jun 29;7(3):e0084121. doi: 10.1128/msphere.00841-21. Epub 2022 May 19.
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. 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.
在过去的 2 年里，严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）已在全球范围内导致数百万人死亡。美国的传播情况因地理位置和社会因素而异，而北卡罗来纳州的数据很少。在这里，我们描述了 2020 年 4 月 19 日至 12 月 26 日期间，通过北卡罗来纳大学健康系统的四个临床站点收集的 12471 个独特的医院剩余样本的每周横断面研究结果，这些样本主要来自北卡罗来纳州中部的城市、门诊人群。我们采用贝叶斯推断模型来计算 SARS-CoV-2 刺突蛋白免疫球蛋白流行率估计值和血清阳性的条件优势比。此外，我们分析了这些血清阳性样本的一部分用于中和抗体。我们观察到，在研究过程中，血清阳性率从 2.9（95%置信区间[CI]，1.8 至 4.5）增加到 12.8（95%CI，10.6 至 15.2）。拉丁裔个体的 SARS-CoV-2 暴露几率最高，为 6.56（95%CI，4.66 至 9.44）。我们的研究结果有助于通过种族群体量化 SARS-CoV-2 暴露的程度。我们还发现，在一个血清阳性个体的亚组中，有 49%的个体存在可检测的中和抗体，这偏向于那些有近期呼吸道感染症状的个体。PCR 确诊的 SARS-CoV-2 病例低估了真实的流行率。2020 年，北卡罗来纳州很少有关于 SARS-CoV-2 种族和整体流行率的可靠社区水平估计值公布。死亡率集中在种族少数群体中，可能是由于 SARS-CoV-2 暴露的可能性很高，我们观察到北卡罗来纳州的拉丁裔个体的暴露可能性特别高。此外，中和抗体滴度是保护的已知相关因素。我们观察到，SARS-CoV-2 中和抗体的产生可能不一致且取决于症状的严重程度，这使得接种疫苗成为当务之急，尽管之前已经暴露过。
