Estimated SARS-CoV-2 Seroprevalence in US Patients Receiving Dialysis 1 Year After the Beginning of the COVID-19 Pandemic.
Estimated SARS-CoV-2 Seroprevalence in US Patients Receiving Dialysis 1 Year After the Beginning of the COVID-19 Pandemic.
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DOI：
10.1001/jamanetworkopen.2021.16572
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发表时间：
2021-07-01
影响因子：
13.8
通讯作者：
Chertow GM
中科院分区：
文献类型：
--
作者：
Anand S;Montez-Rath M;Han J;Cadden L;Hunsader P;Kerschmann R;Beyer P;Boyd SD;Garcia P;Dittrich M;Block GA;Parsonnet J;Chertow GM
这项横断面研究使用来自美国一家透析机构的数据，评估接受透析的患者中SARS-CoV-2抗体的血清阳性率，并估计COVID-19大流行1年后成年人群的血清阳性率。截至2021年1月，美国接受透析的患者和成年人群中SARS-CoV-2血清阳性率是多少？在这项对21464名在美国接受透析的患者进行的横断面研究中，这些患者广泛代表了SARS-CoV-2感染风险最高的人群（例如，老年人、种族/少数民族群体成员），SARS-CoV-2血清阳性率为18.9%。美国各地区的血清阳性率变化不大。年轻人，那些生活在社区与大多数西班牙裔人口，和那些生活在低收入社区的人群血清阳性率最高。在将接受透析的患者的血清阳性率标准化为美国成年人群后，这项研究的结果表明，到2021年1月，大多数成年人没有自然感染SARS-CoV-2的证据。在评估SARS-CoV-2病毒的累积传播时，血清阳性率研究补充了关于检出病例和归因死亡的数据。估计2021年1月在COVID-19疫苗广泛引入之前，美国接受透析的患者和成人中SARS-CoV-2抗体的血清阳性率。这项横断面研究使用了美国第三大透析组织（US Renal Care）的数据，该组织在全国范围内设有设施，以估计接受透析的美国患者中的SARS-CoV-2血清阳性率。对2021年1月1日至31日在美国肾脏护理机构接受透析的所有患者的剩余血浆（即，否则将被丢弃的血浆）进行SARS-CoV-2抗体检测。如果患者有记录的SARS-CoV-2疫苗接种剂量或电子病历中缺少居住地邮政编码，则将其排除在外。使用2018年美国社区调查1年估计值，将该样本（2021年1月）的粗血清阳性率估计值标准化为美国成年人群，并按年龄组、性别、自我报告的种族/民族、社区种族/民族组成、社区收入水平和城市或农村状况分层。然后将这些数据和病例检出率与2020年7月在同一设施接受透析的患者子样本的数据进行比较。年龄、性别、种族/民族和居住地区以及社区种族/民族构成、贫困、人口密度和城市或农村状况。使用刺突蛋白受体结合域总抗体检测（Siemens Healthineers; Embrerer报告的灵敏度为100%，特异性为99.8%）估计未加权样本中的SARS-CoV-2粗血清阳性率，然后计算美国透析和成人人群的估计血清阳性率，并根据年龄、性别和地区进行调整。自2021年1月起，共有21464例患者（平均[SD]年龄为63.1 [14.2]岁; 12265例男性[57%]）被纳入未加权样本。患者年龄偏大（年龄65-79岁，7847例[37%];年龄≥80岁，2668例[12%]），且为少数种族/族裔组成员（西班牙裔患者，2945例[18%];非西班牙裔黑人患者，4875例[29%]）。样本中SARS-CoV-2抗体的血清阳性率为18.9%（95%CI，18.3%-19.5%），标准化为美国透析人群的血清阳性率为18.7%（95%CI，18.1%-19.2%），标准化为美国成人人群的血清阳性率为21.3%（95%CI，20.3%-22.3%）。在未加权样本中，（年龄18-44岁，25.9%; 95% CI，24.1%-27.8%），自认为是西班牙裔或居住在西班牙裔社区的人（25.1%; 95%CI，23.6%-26.4%）和生活在最低收入社区的人（24.8%; 95%CI，23.2%-26.5%）是血清阳性率最高的亚组。在2021年1月的样本中，不同地理区域、人口密度和城市或农村状况的血清阳性率几乎没有变化（最大区域差异，东北部居民的血清阳性率比西部居民高1.2 [95% CI，1.1-1.3]）。在这项对美国接受透析的患者进行的横断面研究中，在美国检测到首例SARS-CoV-2感染后1年，不到1/4的患者有SARS-CoV-2抗体的证据。标准化为美国人群的结果表明，美国成年人的抗体流行率相似。向年轻人、居住在少数种族/民族居民较多的社区的人以及居住在低收入社区的人引入疫苗可能对阻断感染传播至关重要。
This cross-sectional study uses data from a dialysis organization in the US to assess the seroprevalence of SARS-CoV-2 antibodies among patients receiving dialysis and to estimate the seroprevalence among the adult population 1 year into the COVID-19 pandemic. What is the SARS-CoV-2 seroprevalence among patients receiving dialysis and the adult population in the US as of January 2021? In this cross-sectional study of 21 464 patients receiving dialysis in the US, who broadly represent persons most at risk of to SARS-CoV-2 infection (eg, older people, members of racial/ethnic minority groups), the SARS-CoV-2 seroprevalence was 18.9%. Seroprevalence varied little by US region. Younger persons, those living in communities with a majority Hispanic population, and those living in lower-income neighborhoods were the groups with the highest seroprevalence rates. After standardizing seroprevalence rates for patients receiving dialysis to the US adult population, results of this study suggest that most adults did not have evidence of natural SARS-CoV-2 infection by January 2021. Seroprevalence studies complement data on detected cases and attributed deaths in assessing the cumulative spread of the SARS-CoV-2 virus. To estimate seroprevalence of SARS-CoV-2 antibodies in patients receiving dialysis and adults in the US in January 2021 before the widespread introduction of COVID-19 vaccines. This cross-sectional study used data from the third largest US dialysis organization (US Renal Care), which has facilities located nationwide, to estimate SARS-CoV-2 seroprevalence among US patients receiving dialysis. Remainder plasma (ie, plasma that would have otherwise been discarded) of all patients receiving dialysis at US Renal Care facilities from January 1 to 31, 2021, was tested for SARS-CoV-2 antibodies. Patients were excluded if they had a documented dose of SARS-CoV-2 vaccination or if a residence zip code was missing from electronic medical records. Crude seroprevalence estimates from this sample (January 2021) were standardized to the US adult population using the 2018 American Community Survey 1-year estimates and stratified by age group, sex, self-reported race/ethnicity, neighborhood race/ethnicity composition, neighborhood income level, and urban or rural status. These data and case detection rates were then compared with data from a July 2020 subsample of patients who received dialysis at the same facilities. Age, sex, race/ethnicity, and region of residence as well as neighborhood race/ethnicity composition, poverty, population density, and urban or rural status. The spike protein receptor-binding domain total antibody assay (Siemens Healthineers; manufacturer-reported sensitivity of 100% and specificity of 99.8%) was used to estimate crude SARS-CoV-2 seroprevalence in the unweighted sample, and then the estimated seroprevalence rates for the US dialysis and adult populations were calculated, adjusting for age, sex, and region. A total of 21 464 patients (mean [SD] age, 63.1 [14.2] years; 12 265 men [57%]) were included in the unweighted sample from January 2021. The patients were disproportionately older (aged 65-79 years, 7847 [37%]; aged ≥80 years, 2668 [12%]) and members of racial/ethnic minority groups (Hispanic patients, 2945 [18%]; non-Hispanic Black patients, 4875 [29%]). Seroprevalence of SARS-CoV-2 antibodies was 18.9% (95% CI, 18.3%-19.5%) in the sample, with a seroprevalence of 18.7% (95% CI, 18.1%-19.2%) standardized to the US dialysis population, and 21.3% (95% CI, 20.3%-22.3%) standardized to the US adult population. In the unweighted sample, younger persons (aged 18-44 years, 25.9%; 95% CI, 24.1%-27.8%), those who self-identified as Hispanic or living in Hispanic neighborhoods (25.1%; 95% CI, 23.6%-26.4%), and those living in the lowest-income neighborhoods (24.8%; 95% CI, 23.2%-26.5%) were among the subgroups with the highest seroprevalence. Little variability was observed in seroprevalence by geographic region, population density, and urban or rural status in the January 2021 sample (largest regional difference, 1.2 [95% CI, 1.1-1.3] higher odds of seroprevalence in residents of the Northeast vs West). In this cross-sectional study of patients receiving dialysis in the US, fewer than 1 in 4 patients had evidence of SARS-CoV-2 antibodies 1 year after the first case of SARS-CoV-2 infection was detected in the US. Results standardized to the US population indicate similar prevalence of antibodies among US adults. Vaccine introduction to younger individuals, those living in neighborhoods with a large population of racial/ethnic minority residents, and those living in low-income neighborhoods may be critical to disrupting the spread of infection.
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DOI：
10.1136/bmj.m4509
发表时间：
2020-11-27
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Pastor-Barriuso R;Pérez-Gómez B;Hernán MA;Pérez-Olmeda M;Yotti R;Oteo-Iglesias J;Sanmartín JL;León-Gómez I;Fernández-García A;Fernández-Navarro P;Cruz I;Martín M;Delgado-Sanz C;Fernández de Larrea N;León Paniagua J;Muñoz-Montalvo JF;Blanco F;Larrauri A;Pollán M;ENE-COVID Study Group
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ENE-COVID Study Group
DOI：
10.1016/s0140-6736(21)00183-5
发表时间：
2021-02-06
期刊：
Lancet (London, England)
影响因子：
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作者：
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通讯作者：
Faria NR
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10.1016/s1473-3099(20)30943-9
发表时间：
2021-03
期刊：
The Lancet. Infectious diseases
影响因子：
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作者：
Duysburgh E;Mortgat L;Barbezange C;Dierick K;Fischer N;Heyndrickx L;Hutse V;Thomas I;Van Gucht S;Vuylsteke B;Ariën KK;Desombere I
通讯作者：
Desombere I
DOI：
10.1016/s0140-6736(20)32137-1
发表时间：
2020-11-14
期刊：
Lancet (London, England)
影响因子：
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作者：
Poland GA;Ovsyannikova IG;Kennedy RB
通讯作者：
Kennedy RB
影响因子：
13.6
作者：
Levin AT;Hanage WP;Owusu-Boaitey N;Cochran KB;Walsh SP;Meyerowitz-Katz G
通讯作者：
Meyerowitz-Katz G