U.S. COVID Infections ‘More Widespread’ Than Thought?

March 17, 2021 – According to a new study, 16 million more Americans were infected with COVID-19 in the first 9 months of 2020 compared to previous reports.

Investigators assessed 61,910 adults who reported feeling good when they applied for life insurance. A total of 4,094, or 6.6%, had a positive coronavirus antibody test, meaning they were previously infected with the virus.

The discovery “would double the number of people infected with COVID-19 compared to the number of clinically diagnosed cases,” senior author Robert L. Stout, PhD, scientific director of the Clinical Reference Laboratory, Inc at Lenexa, told Medscape, KS. .

In September, the scope of the pandemic was about double the number of reported cases, “added Stout.” It’s not like measles, where it is easily identifiable. Quite simply, for the asymptomatic patient, they think everything is fine and continue to go about their normal activities. Some practices recommend CDC guidelines in public places, some do not. “

The research letter was published online on March 16 at JAMA network open.

After investigators assessed the national sample in September, they used that data to estimate the total number of undiagnosed cases in the United States based on census data.

Comparison of Gender, Age and State by State

The cross-sectional study included age, sex, residence status, and antibody status. The average age of those participating in the study was 39 years old. Of the 4,094 positive cases, 54% were males.

The infection rate was slightly higher in women, 6.9%, compared to 6.4% in men.

The lowest infection rate was 2.8% in asymptomatic people over 70 years of age. In contrast, the youngest cohort up to age 30 had the highest rate, at 9.8%.

Infection rates varied widely by condition, ”noted Stout and his co-author Steven Rigatti, MD, of MassMutual.

The highest rate in September was 14.4% in New York City, followed by 12% in Louisiana and 10% in Nevada. The states with the lowest rates included Oregon with 1.5%, Maine with 0.6%, and Alaska with 0%.

Implications and skepticism

“Our estimate involved more than twice as many infections as cases reported to the Centers for Disease Control and Prevention,” the researchers note, “suggesting a more widespread pandemic.”

Potential limitations of the study include self-reporting of health – all people reported feeling well – and evaluation of submitted blood tests against a random sample of the general population.

“Overall, it’s difficult to interpret the results because the study sample was a convenience sample of people applying for life insurance,” Neeraj Sood, PhD, told Medscape.

The numbers could even be higher. “People who apply for life insurance tend to be more educated, wealthier and possibly more risk averse. The results of this study therefore do not generalize to the general population and probably represent a lower limit of true seroprevalence in the general population, ”said Sood, director of the COVID Initiative at the University of Southern California Schaeffer Center in Los Angeles.

Sood was the principal author of a JAMAresearch letter published in May assessing infection rate in Los Angeles County adults.

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