Dataset Information

Seroprevalence of SARS-CoV-2 Among Skilled Nursing Facility Residents and Staff Members - Los Angeles County, August-September 2020.

ABSTRACT:

Background

The prevalence of current/past coronavirus disease 2019 (COVID-19) in skilled nursing facility (SNF) residents is unknown because of asymptomatic infection and constrained testing capacity early in the pandemic. We conducted a seroprevalence survey (SPS) to determine a more comprehensive prevalence of past COVID-19 in Los Angeles County SNF residents and staff members.

Methods

We recruited participants from 24 facilities; participants were requested to submit a nasopharyngeal (NP) swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR testing and serum for detection of SARS-CoV-2 antibodies. All participants were cross-referenced with our surveillance database to identify persons with prior positive SARS-CoV-2 results.

Results

From August 18 to September 24, 2020, we enrolled 3,305 participants (1,340 residents and 1,965 staff members). Among 856 residents providing serum, 362 (42%) had current/past SARS-CoV-2 infection. Of the 346 serology positive residents, 199 (58%) did not have a documented prior positive SARS-CoV-2 PCR result. Among 1,806 staff members providing serum, 454 (25%) had current/past SARS-CoV-2 infection. Of the 447 serology positive staff members, 353 (79%) did not have a documented prior positive SARS-CoV-2 PCR result.

Conclusions

Past testing practices and policies missed a substantial number of SARS-CoV-2 infections in SNF residents and staff members.

SUBMITTER: Malenfant JH

PROVIDER: S-EPMC8243593 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:ObjectiveTo describe the frequency and timing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody detection in a convenience sample of skilled nursing facility (SNF) residents with and without confirmed SARS-CoV-2 infection.DesignRetrospective analysis of SNF electronic health records.SettingQualitative SARS-CoV-2 antibody test results were available from 81 SNFs in 16 states.ParticipantsSix hundred and sixty nine SNF residents who underwent both polymerase chain reaction (PCR) and antibody testing for SARS-CoV-2.MeasurementsPresence of SARS-CoV-2 antibodies following the first positive PCR test for confirmed cases, or first PCR test for non-cases.ResultsAmong 397 residents with PCR-confirmed infection, antibodies were detected in 4 of 7 (57.1%) tested within 7-14 days of their first positive PCR test; in 44 of 47 (93.6%) tested within 15-30 days; in 182 of 219 (83.1%) tested within 31-60 days; and in 110 of 124 (88.7%) tested after 60 days. Among 272 PCR negative residents, antibodies were detected in 2 of 9 (22.2%) tested within 7-14 days of their first PCR test; in 41 of 81 (50.6%) tested within 15-30 days; in 65 of 148 (43.9%) tested within 31-60 days; and in 9 of 34 (26.5%) tested after 60 days. No significant differences in baseline resident characteristics or symptoms were observed between those with versus without antibodies.ConclusionsThese findings suggest that vulnerable older adults can mount an antibody response to SARS-CoV-2, and that antibodies are most likely to be detected within 15-30 days of diagnosis. That antibodies were detected in a large proportion of residents with no confirmed SARS-CoV-2 infection highlights the complexity of identifying who is infected in real time. Frequent surveillance and diagnostic testing based on low thresholds of clinical suspicion for symptoms and/or exposure will remain critical to inform strategies designed to mitigate outbreaks in SNFs while community SARS-CoV-2 prevalence remains high.