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

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dc.contributor.authorRogawski McQuade, Elizabeth T.en
dc.contributor.authorBecker, Leaen
dc.contributor.authorStroup, Suzanne E.en
dc.contributor.authorKhan, Fauziaen
dc.contributor.authorShah, Bhrugaen
dc.contributor.authorBrush, Johnen
dc.contributor.authorGoldsmith, Gayen
dc.contributor.authorMullin, Rebeccaen
dc.contributor.authorGuilliams, Danielleen
dc.contributor.authordeFilippi, Christopheren
dc.contributor.authorBarackman, Kathleenen
dc.contributor.authorMohr, Andrea B.en
dc.contributor.authorFarrell, Francesen
dc.contributor.authorBearman, Gonzaloen
dc.contributor.authorPeake, Lilianen
dc.contributor.authorHoupt, Eric R.en
dc.date.accessioned2024-01-08T21:56:57Zen
dc.date.available2024-01-08T21:56:57Zen
dc.date.issued2023-10-11en
dc.description.abstractBackground: Virginia 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. Methods: Using 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. Results: The 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. Conclusions: In 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.en
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier676 (Article number)en
dc.identifier.doihttps://doi.org/10.1186/s12879-023-08670-6en
dc.identifier.eissn1471-2334en
dc.identifier.issn1471-2334en
dc.identifier.issue1en
dc.identifier.orcidFarrell, Frances [0000-0002-8105-1015]en
dc.identifier.other10.1186/s12879-023-08670-6 (PII)en
dc.identifier.pmid37821853en
dc.identifier.urihttps://hdl.handle.net/10919/117320en
dc.identifier.volume23en
dc.language.isoenen
dc.publisherSpringeren
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pubmed/37821853en
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectCOVID-19en
dc.subjectNucleocapsiden
dc.subjectRisk factorsen
dc.subjectSARS-CoV-2en
dc.subjectSeroepidemiologyen
dc.subjectSpikeen
dc.subjectVaccineen
dc.subject.meshHumansen
dc.subject.meshAntibodies, Viralen
dc.subject.meshRisk Factorsen
dc.subject.meshLongitudinal Studiesen
dc.subject.meshSeroepidemiologic Studiesen
dc.subject.meshAdulten
dc.subject.meshMiddle Ageden
dc.subject.meshChilden
dc.subject.meshVirginiaen
dc.subject.meshAntibodies, Neutralizingen
dc.subject.meshCOVID-19en
dc.subject.meshSARS-CoV-2en
dc.subject.meshCOVID-19 Vaccinesen
dc.titleRisk factors and titers of COVID-19 infection in a longitudinal statewide seroepidemiology cohorten
dc.title.serialBMC Infectious Diseasesen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherJournal Articleen
dcterms.dateAccepted2023-10-04en
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicineen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Internal Medicineen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Internal Medicine/General IMen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/TEACH Membersen

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