Temporal Variations in Seroprevalence of Severe Acute Respiratory Syndrome Coronavirus 2 Infections by Race and Ethnicity in Arkansas
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Abstract
Background
The aim of this study was to estimate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates in the small rural state of Arkansas, using SARS-CoV-2 antibody prevalence as an indicator of infection.
Methods
We collected residual serum samples from adult outpatients seen at hospitals or clinics in Arkansas for non–coronavirus disease 2019 (COVID-19)–related reasons. A total of 5804 samples were identified over 3 time periods: 15 August–5 September 2020 (time period 1), 12 September–24 October 2020 (time period 2), and 7 November–19 December 2020 (time period 3).
Results
The age-, sex-, race-, and ethnicity-standardized SARS-CoV-2 seroprevalence during each period, from 2.6% in time period 1 to 4.1% in time period 2 and 7.4% in time period 3. No statistically significant difference in seroprevalence was found based on age, sex, or residence (urban vs rural). However, we found higher seroprevalence rates in each time period for Hispanics (17.6%, 20.6%, and 23.4%, respectively) and non-Hispanic Blacks (4.8%, 5.4%, and 8.9%, respectively) relative to non-Hispanic Whites (1.1%, 2.6%, and 5.5%, respectively).
Conclusions
Our data imply that the number of Arkansas residents infected with SARS-CoV-2 rose steadily from 2.6% in August to 7.4% in December 2020. There was no statistical difference in seroprevalence between rural and urban locales. Hispanics and Blacks had higher rates of SARS-CoV-2 antibodies than Whites, indicating that SARS-CoV-2 spread disproportionately in racial and ethnic minorities during the first year of the COVID-19 pandemic.
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SciScore for 10.1101/2021.07.15.21260213: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study was reviewed and approved by the UAMS Institutional Review Board and waiver of consent and HIPAA applied. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Antibodies Sentences Resources Laboratory Methods: A two-step process was used to evaluate the sera for CoV-2 antibodies, as suggested by Centers for Disease Control (CDC) guidelines[13]. CoV-2suggested: NoneAll sera were tested for CoV-2 Receptor Binding Domain (RBD) IgG antibodies using the Beckman Coulter (BC) Access SARS-CoV-2 IgG (Brea, CA) in the Clinical Laboratory at the UAMS main campus. CoV-2 Receptor Binding Domain (RBD) IgGsuggested: …SciScore for 10.1101/2021.07.15.21260213: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The study was reviewed and approved by the UAMS Institutional Review Board and waiver of consent and HIPAA applied. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Antibodies Sentences Resources Laboratory Methods: A two-step process was used to evaluate the sera for CoV-2 antibodies, as suggested by Centers for Disease Control (CDC) guidelines[13]. CoV-2suggested: NoneAll sera were tested for CoV-2 Receptor Binding Domain (RBD) IgG antibodies using the Beckman Coulter (BC) Access SARS-CoV-2 IgG (Brea, CA) in the Clinical Laboratory at the UAMS main campus. CoV-2 Receptor Binding Domain (RBD) IgGsuggested: NoneFour-Antigen Confirmation Test (FACT): The laboratory-derived assay in this study was designed considering prior ELISAs for CoV-2 antibodies[14]. antibodies[14suggested: NoneThe plates were washed three times with PBS-T and incubated with 50 µL of secondary antibody solution anti-human IgG + IgM (Jackson ImmunoResearch) diluted 1:5000 in PBS-T + 1% milk) for 1h at RT. anti-human IgG + IgMsuggested: NoneSoftware and Algorithms Sentences Resources All clinical and demographic variables were stored in a protected REDCap database[10, 11] and included patient age, gender, race, ethnicity, ZIP Code, and county of residence. REDCapsuggested: (REDCap, RRID:SCR_003445)All analyses were conducted using SAS, version 9.4. SASsuggested: (SASqPCR, RRID:SCR_003056)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Benefits and limitations of convenience sampling techniques have been discussed elsewhere[20]. It is possible that our sampling method could favor subjects who were more ill (e.g., individuals who were hospitalized) or more willing to leave their homes (e.g., individuals when were evaluated in clinics), etc. Nonetheless, the seroprevalence observed is consistent with both reported infections and data from American Red Cross blood donations in southern US states[21] and the Centers for Disease Control Multi-State Assessment of SARS-CoV-2 Seroprevalence (MASS-C)[22], which increases confidence in our data. The American Red Cross blood study found only 2.9% seroprevalence from August to September in southern states, while the MASS-C data revealed 9.2% seroprevalence in December in Arkansas. It should be noted that these earlier studies had no[17] or low (n=1071 Arkansas samples)[22] representation from Arkansas. Taken together, the data support the conclusion that the while seroprevalence rates demonstrate that more Arkansans have been infected with CoV-2 than previously recognized, the majority of the population in a representative rural southern state was not infected by CoV-2 from March to December of 2020. This, in combination with slow vaccine uptake despite rapid distribution of vaccinations across the State, has left many people vulnerable to CoV-2 infection with variants of concern. In fact, this spring, Arkansas is experiencing an uptick in cases, ranking second in high...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
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Results from scite Reference Check: We found no unreliable references.
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