Dataset Information

Undiagnosed SARS-CoV-2 seropositivity during the first 6 months of the COVID-19 pandemic in the United States.

ABSTRACT: Asymptomatic SARS-CoV-2 infection and delayed implementation of diagnostics have led to poorly defined viral prevalence rates in the United States and elsewhere. To address this, we analyzed seropositivity in 9089 adults in the United States who had not been diagnosed previously with COVID-19. Individuals with characteristics that reflected the U.S. population (n = 27,716) were selected by quota sampling from 462,949 volunteers. Enrolled participants (n = 11,382) provided medical, geographic, demographic, and socioeconomic information and dried blood samples. Survey questions coincident with the Behavioral Risk Factor Surveillance System survey, a large probability-based national survey, were used to adjust for selection bias. Most blood samples (88.7%) were collected between 10 May and 31 July 2020 and were processed using ELISA to measure seropositivity (IgG and IgM antibodies against SARS-CoV-2 spike protein and the spike protein receptor binding domain). The overall weighted undiagnosed seropositivity estimate was 4.6% (95% CI, 2.6 to 6.5%), with race, age, sex, ethnicity, and urban/rural subgroup estimates ranging from 1.1% to 14.2%. The highest seropositivity estimates were in African American participants; younger, female, and Hispanic participants; and residents of urban centers. These data indicate that there were 4.8 undiagnosed SARS-CoV-2 infections for every diagnosed case of COVID-19, and an estimated 16.8 million infections were undiagnosed by mid-July 2020 in the United States.

SUBMITTER: Kalish H

PROVIDER: S-EPMC8432952 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Undiagnosed SARS-CoV-2 seropositivity during the first 6 months of the COVID-19 pandemic in the United States.

Kalish Heather H Klumpp-Thomas Carleen C Hunsberger Sally S Baus Holly Ann HA Fay Michael P MP Siripong Nalyn N Wang Jing J Hicks Jennifer J Mehalko Jennifer J Travers Jameson J Drew Matthew M Pauly Kyle K Spathies Jacquelyn J Ngo Tran T Adusei Kenneth M KM Karkanitsa Maria M Croker Jennifer A JA Li Yan Y Graubard Barry I BI Czajkowski Lindsay L Belliveau Olivia O Chairez Cheryl C Snead Kelly R KR Frank Peter P Shunmugavel Anandakumar A Han Alison A Giurgea Luca T LT Rosas Luz Angela LA Bean Rachel R Athota Rani R Cervantes-Medina Adriana A Gouzoulis Monica M Heffelfinger Brittany B Valenti Shannon S Caldararo Rocco R Kolberg Michelle M MM Kelly Andrew A Simon Reid R Shafiq Saifullah S Wall Vanessa V Reed Susan S Ford Eric W EW Lokwani Ravi R Denson John-Paul JP Messing Simon S Michael Sam G SG Gillette William W Kimberly Robert P RP Reis Steven E SE Hall Matthew D MD Esposito Dominic D Memoli Matthew J MJ Sadtler Kaitlyn K

Science translational medicine 20210622 601

Asymptomatic SARS-CoV-2 infection and delayed implementation of diagnostics have led to poorly defined viral prevalence rates in the United States and elsewhere. To address this, we analyzed seropositivity in 9089 adults in the United States who had not been diagnosed previously with COVID-19. Individuals with characteristics that reflected the U.S. population (<i>n</i> = 27,716) were selected by quota sampling from 462,949 volunteers. Enrolled participants (<i>n</i> = 11,382) provided medical, ...[more]

PMID: 34158410

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Project description:ImportanceThe COVID-19 pandemic disrupted the normal course of cancer screening and detection in the US. A nationwide analysis of the extent of this disruption using cancer registry data has not been conducted.ObjectiveTo assess the observed and expected cancer rate trends for March through December 2020 using data from all 50 US states and the District of Columbia.Design, settings, and participantsThis was a population-based cross-sectional analysis of cancer incidence trends using data on cases of invasive cancer diagnosis reported to the US Cancer Statistics from January 1, 2018, through December 31, 2020. Data analyses were performed from July 6 to 28, 2023.Exposure(s)Age, sex, race, urbanicity, and state-level response to the COVID-19 pandemic at the time of cancer diagnosis.Main outcomes and measuresUsed time-series forecasting methods to calculate expected cancer incidence rates for March 1 through December 31, 2020, from prepandemic trends (January 2018-February 2020). Measured relative difference between observed and expected cancer incidence rates and numbers of potentially missed cancer cases.ResultsThis study included 1 297 874 cancer cases reported in the US from March 1 through December 31, 2020, with an age-adjusted incidence rate of 326.5 cases per 100 000 population. Of the observed cases, 657 743 (50.7%) occurred in male patients, 757 106 (58.3%) in persons 65 years or older, and 1 066 566 (82.2%) in White individuals. Observed rates of all-sites cancer incidence in the US were 28.6% (95% prediction interval [PI], 25.4%-31.7%) lower than expected during the height of the COVID-19 pandemic response (March-May 2020); 6.3% (95% PI, 3.8%-8.8%) lower in June to December 2020; and overall, 13.0% (95% PI, 11.2%-14.9%) lower during the first 10 months of the pandemic. These differences indicate that there were potentially 134 395 (95% PI, 112 544-156 680) undiagnosed cancers during that time frame. Prostate cancer accounted for the largest number of potentially missed cases (22 950), followed by female breast (16 870) and lung (16 333) cancers. Screenable cancers saw a total rate reduction of 13.9% (95% PI, 12.2%-15.6%) compared with the expected rate. The rate of female breast cancer showed evidence of recovery to previous trends after the first 3 months of the pandemic, but levels remained low for colorectal, cervical, and lung cancers. From March to May 2020, states with more restrictive COVID-19 responses had significantly greater disruptions, yet by December 2020, these differences were nonsignificant for all sites except lung, kidney, and pancreatic cancer.Conclusions and relevanceThis cross-sectional analysis of cancer incidence trends found a substantial disruption to cancer diagnoses in the US during the first 10 months of the COVID-19 pandemic. The overall and differential findings can be used to inform where the US health care system should be looking to make up ground in cancer screening and detection.

Dataset Information

Undiagnosed SARS-CoV-2 seropositivity during the first 6 months of the COVID-19 pandemic in the United States.

Publications

Undiagnosed SARS-CoV-2 seropositivity during the first 6 months of the COVID-19 pandemic in the United States.

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