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SARS-CoV-2 Prevalence Similar in
Adults and Children in 15-Site US Study
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2022 CROI, February 12-16 and 22-24, 2022
Mark Mascolini
SARS-CoV-2 prevalence in 15 largely urban US communities proved virtually identical in adults (18 or older) and children, a finding at odds with earlier research [1]. About three quarters of participants affirmed their willingness to get a COVID vaccination.
Despite the omnipresence of SARS-CoV-2 on scientific agendas-and in the world-surprisingly scanty data address seroprevalence of the novel coronavirus "in rigorously sampled and geographically broad populations," especially in children, said researchers from ICAP at Columbia University and other centers collaborating in the COMPASS study. To remedy this shortcoming, the COMPASS group assessed cross-sectional SARS-CoV-2 seroprevalence and PCR positivity in adults and children in 15 US communities.
Study sites spanned the Northeast, Midwest, and South, with one site in Colorado. The communities were picked because of their proximity to participating research centers and thus were largely urban. The COMPASS team used time-location sampling to recruit adults and children older than 2 months at randomly selected venues, aiming for 2920 participants per site. Participants gave demographic, clinical, and behavioral information in response to a questionnaire read by a staff member. People also related any history or symptoms of COVID-19 and rated their willingness to get an approved COVID vaccine. They gave a blood sample for serologic testing indicating prior infection (SARS-CoV-2 nucleocapsid antibody assay) and a mid-turbinate nasal secretion sample for PCR determination of active infection.
Of about 69,000 people approached at community venues from January to August 2021 (before the Omicron variant struck), 22,667 enrolled, including 2133 children (9.4%) under 18 years old. The combined antibody/PCR sample included 21,398 people who gave blood and nasal swab samples. Median participants per community stood at 1246, including a median of 49 children per community. The overall study group had similar proportions of blacks and whites.
Overall antibody positivity indicating prior infection (seroprevalence) measured 12.4%, while 0.8% tested PCR positive, indicating active infection. Overall prevalence of prior or active infection (12.9%) did not differ by sex but was moderately higher in blacks than whites and in Hispanics than non-Hispanics. Rates of prior or active infection were nearly identical in adults and children. Slightly more than half of seropositive people (51.3%) had no symptoms, and a slightly higher proportion tested PCR-positive with no symptoms (55.8%).
Just over three quarters of participants, 78%, reported willingness to get a COVID vaccine, and that response rate did not differ between women and men. Vaccine willingness was lowest in children under 18 years old (about 60%), higher in the 18-to-39 group and the 40-to-59 group (about 75%), and highest in the 60-and-older group (almost 90%). A higher proportion of whites than blacks were willing to get vaccinated, but vaccine willingness did not differ between Hispanics and non-Hispanics.
The COMPASS investigators stressed that their finding of similar SARS-CoV-2 prevalence in children and adults departs from previous studies and indicates the "acquisition of SARS-CoV-2 does not vary by age." The high proportion of antibody- and PCR-positive people without symptoms-just over half-underlines the limitations of case-based reporting. The researchers cautioned that selection of interview sites close to participating research centers limits generalizability of results.
Reference
1. Justman JE, Skalland TM, Moore A, et al. SARS-CoV-2 prevalence in children and adults in 15 US communities: the COMPASS Study. 2022 CROI, February 12-16 and 22-24, 2022. Abstract 46.
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