Cross-sectional study examining household factors associated with SARS-CoV-2 seropositivity in low-income children in Los Angeles

BMJ Open. 2023 May 31;13(5):e070291. doi: 10.1136/bmjopen-2022-070291.

Abstract

Objectives: This study aims to quantify the degree to which an underserved, Hispanic population in Los Angeles is impacted by SARS-CoV-2, and determine factors associated with paediatric seropositivity.

Design: Cross-sectional.

Setting: AltaMed, a Federally Qualified Health Center in Los Angeles.

Participants: A random sample of households who had received healthcare at AltaMed Medical Group was invited to participate. Households with at least one adult and one paediatric participant between 5 and 17 years of age were eligible to participate. Consented participants completed a survey on social determinants of health and were tested for antibodies using Abbott Architect SARS-CoV-2-IgG and SARS-CoV-2-IgM tests.

Primary outcome measure: Seropositive status.

Results: We analysed 390 adults (mean age in years, 38.98 (SD 12.11)) and 332 paediatric participants (11.26 (SD 3.51)) from 196 households. Estimated seropositivity was 52.11% (95% CI 49.61% to 55.19%) in paediatric participants and 63.58% (95% CI 60.39% to 65.24%) in adults. Seropositivity was 11.47% (95% CI 6.82% to 14.09%) lower in paediatric participants, but high relative to other populations. A household member with type 2 diabetes (OR 2.94 (95% CI 1.68 to 5.14)), receipt of food stamps (OR 1.66 (95% CI 1.08 to 2.56)) and lower head-of-household education (OR 1.73 (95% CI 1.06 to 2.84)) were associated with paediatric seropositivity.

Conclusions: SARS-CoV-2 seropositivity is high in Hispanic children and adolescents in Los Angeles. Food insecure households with low head-of-household education, and at least one household member with type 2 diabetes, had the highest risk. These factors may inform paediatrician COVID-19 mitigation recommendations.

Trial registration number: NCT04901624.

Keywords: COVID-19; community child health; public health.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral
  • COVID-19* / epidemiology
  • Child
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2*
  • Humans
  • Los Angeles / epidemiology
  • SARS-CoV-2
  • Seroepidemiologic Studies

Substances

  • Antibodies, Viral

Associated data

  • ClinicalTrials.gov/NCT04901624