One year after the first SARS-CoV-2 case was reported in the US, and before widespread COVID-19 vaccination, the seroprevalence of the novel coronavirus was relatively low among adults receiving dialysis, investigators reported in JAMA Network Open.

Among 21,464 unvaccinated patients attending US Renal Care clinics in January 2021, 18.9% had antibodies to SARS CoV-2, Shuchi Anand, MD, MS, and colleagues from Stanford University in Palo Alto, California, reported. When standardized to the US population, the seroprevalence was estimated to be 18.7% among dialysis recipients and 21.3% among US adults.

Seroprevalence varied little by US region in January 2021. The highest seroprevalence was found among younger adults aged 18-44 years (25.9%), those who self-identified as Hispanic or living in predominantly Hispanic neighborhoods (25.1%), and those living in the lowest-income neighborhoods (24.8%).

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The new seroprevalence data extend findings from the team’s July 2020 assessment published in The Lancet. Compared with July 2020, seroprevalences in January 2021 were 1.8-, 4.1-, 5.1-, and 5.1-fold higher in the Northeast, Midwest, West, and South, respectively. Ethnic and income disparities persisted. In January 2021, the seroprevalence was 1.7-fold higher in Hispanic vs White neighborhoods, and 2.0-fold higher in low- vs high-income neighborhoods. Over the 6-month period, infection fatality rates decreased from 0.7% to 0.3%.

“Vaccine introduction to younger individuals, those living in neighborhoods with a large population of racial/ethnic minority residents, and those living in low-income neighborhoods may be critical to disrupting the spread of infection,” Dr Anand’s team wrote.

Disclosure: This research was supported by Ascend Clinical Laboratory. Please see the original reference for a full list of disclosures.


Anand S, Montez-Rath M, Han J, et al. Estimated SARS-CoV-2 seroprevalence in US patients receiving dialysis 1 year after the beginning of the COVID-19 pandemic. JAMA Netw Open. Published online July 12, 2021. doi:10.1001/jamanetworkopen.2021.16572