Differentiation of SARS-CoV-2 naturally infected and vaccinated individuals in an inner-city emergency department.

Autor:	Beck EJ; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland., Hsieh YH; Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Fernandez RE; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Dashler G; Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Egbert ER; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland., Truelove SA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Garliss C; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Wang R; Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Bloch EM; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland., Shrestha R; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland., Blankson J; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Cox AL; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Manabe YC; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Kickler T; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland., Rothman RE; Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Redd AD; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland., Tobian AA; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland., Milstone AM; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Quinn TC; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Laeyendecker O; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2021 Oct 14. Date of Electronic Publication: 2021 Oct 14.
DOI:	10.1101/2021.10.13.21264968
Abstrakt:	Background: Emergency Departments (EDs) can serve as surveillance sites for infectious diseases. Our purpose was to determine the burden of SARS-CoV-2 infection and prevalence of vaccination against COVID-19 among patients attending an urban ED in Baltimore City. Methods: Using 1914 samples of known exposure status, we developed an algorithm to differentiate previously infected, vaccinated, and unexposed individuals using a combination of antibody assays. We applied this testing algorithm to 4360 samples ED patients obtained in the springs of 2020 and 2021. Using multinomial logistic regression, we determined factors associated with infection and vaccination. Results: For the algorithm, sensitivity and specificity for identifying vaccinated individuals was 100% and 99%, respectively, and 84% and 100% for naturally infected individuals. Among the ED subjects, seroprevalence to SARS-CoV-2 increased from 2% to 24% between April 2020 and March 2021. Vaccination prevalence rose to 11% by mid-March 2021. Marked differences in burden of disease and vaccination coverage were seen by sex, race, and ethnicity. Hispanic patients, though 7% of the study population, had the highest relative burden of disease (17% of total infections) but similar vaccination rates. Women and White individuals were more likely to be vaccinated than men or Black individuals (adjusted odds ratios [aOR] 1.35 [95% CI: 1.02, 1.80] and aOR 2.26 [95% CI: 1.67, 3.07], respectively). Conclusions: Individuals previously infected with SARS-CoV-2 can be differentiated from vaccinated individuals using a serologic testing algorithm. SARS-CoV-2 exposure and vaccination uptake frequencies reflect gender, race and ethnic health disparities in this urban context. Summary: Using an antibody testing algorithm, we distinguished between immune responses from SARS-CoV-2-infected and vaccinated individuals. When applied to blood samples from an emergency department in Baltimore, disparities in disease burden and vaccine uptake by sex, race, and ethnicity were identified.
Databáze:	MEDLINE
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