{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T08:42:59Z","timestamp":1768552979749,"version":"3.49.0"},"posted":{"date-parts":[[2021,8,11]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":47,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2021,8,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>In comparison to the general patient population, trauma patients show higher level detections of bloodborne infectious diseases, such as Hepatitis and Human Immunodeficiency Virus. In comparison to bloodborne pathogens, the prevalence of respiratory infections such as SARS-CoV-2 and how that relates with other variables, such as drug usage and trauma type, is currently unknown in trauma populations. Here, we evaluated SARS-CoV-2 seropositivity and antibody isotype profile in 2,542 trauma patients from six Level-1 trauma centers between April and October of 2020 during the first wave of the COVID-19 pandemic. We found that the seroprevalence in trauma victims 18-44 years old (9.79%, 95% confidence interval\/CI: 8.33 11.47) was much higher in comparison to older patients (45-69 years old: 6.03%, 4.59-5.88; 70+ years old: 4.33%, 2.54 \u2013 7.20). Black\/African American (9.54%, 7.77 \u2013 11.65) and Hispanic\/Latino patients (14.95%, 11.80 \u2013 18.75) also had higher seroprevalence in comparison, respectively, to White (5.72%, 4.62 7.05) and Non-Latino patients (6.55%, 5.57 \u2013 7.69). More than half (55.54%) of those tested for drug toxicology had at least one drug present in their system. Those that tested positive for narcotics or sedatives had a significant negative correlation with seropositivity, while those on anti-depressants trended positive. These findings represent an important consideration for both the patients and first responders that treat trauma patients facing potential risk of respiratory infectious diseases like SARS-CoV-2.<\/jats:p>","DOI":"10.1101\/2021.08.10.21261849","type":"posted-content","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T14:35:14Z","timestamp":1628692514000},"source":"Crossref","is-referenced-by-count":1,"title":["SARS-CoV-2 Seroprevalence and Drug Use in Trauma Patients from Six Sites in the United States"],"prefix":"10.64898","author":[{"given":"Tran B.","family":"Ngo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Karkanitsa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth M.","family":"Adusei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsey A.","family":"Graham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily E.","family":"Ricotta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenna R.","family":"Darrah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard D.","family":"Blomberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacquelyn","family":"Spathies","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle J.","family":"Pauly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carleen","family":"Klumpp-Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jameson","family":"Travers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Mehalko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Drew","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew D","family":"Hall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J","family":"Memoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominic","family":"Esposito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary A.","family":"Kozar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Griggs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle W.","family":"Cunningham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl I.","family":"Schulman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Crandall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Neavyn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon D.","family":"Dorfman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey T.","family":"Lai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer M.","family":"Whitehill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kavita M.","family":"Babu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas M.","family":"Mohr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon","family":"Van Heukelom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James C.","family":"Fell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Whit","family":"Rooke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Kalish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. Dennis","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2587-8330","authenticated-orcid":false,"given":"Kaitlyn","family":"Sadtler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2021081308150569000_2021.08.10.21261849v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30120-1"},{"key":"2021081308150569000_2021.08.10.21261849v1.2","doi-asserted-by":"crossref","first-page":"545","DOI":"10.15585\/mmwr.mm6918e1","article-title":"Characteristics and clinical outcomes of adult patients hospitalized with COVID-19\u2014Georgia, March 2020","volume":"69","year":"2020","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"2021081308150569000_2021.08.10.21261849v1.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.05.006"},{"key":"2021081308150569000_2021.08.10.21261849v1.4","doi-asserted-by":"crossref","first-page":"864","DOI":"10.15585\/mmwr.mm6927a3","article-title":"Race\/ethnicity, underlying medical conditions, homelessness, and hospitalization status of adult patients with COVID-19 at an urban safety-net medical center\u2014Boston, Massachusetts, 2020","volume":"69","year":"2020","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"2021081308150569000_2021.08.10.21261849v1.5","doi-asserted-by":"crossref","unstructured":"C.A. Lopez , C.H. Cunningham , S. Pugh , K. Brandt , U.P. Vanna , M.J. Delacruz , Q. Guerra , S.J. Goldstein , Y.J. Hou and M. Gearhart : Disparities in SARS-CoV-2 seroprevalence among individuals presenting for care in central North Carolina over a six-month period. medRxiv (2021).","DOI":"10.1101\/2021.03.25.21254320"},{"key":"2021081308150569000_2021.08.10.21261849v1.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa2011686"},{"key":"2021081308150569000_2021.08.10.21261849v1.7","doi-asserted-by":"crossref","first-page":"759","DOI":"10.15585\/mmwr.mm6924e2","article-title":"Coronavirus disease 2019 case surveillance\u2014United States, January 22\u2013May 30, 2020","volume":"69","year":"2020","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"2021081308150569000_2021.08.10.21261849v1.8","doi-asserted-by":"publisher","DOI":"10.7326\/M20-3012"},{"key":"2021081308150569000_2021.08.10.21261849v1.9","unstructured":"C.f.D.C.a. Prevention: HIV Surveillance Report, 2018 (Updated), (2020)."},{"key":"2021081308150569000_2021.08.10.21261849v1.10","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1097\/TA.0000000000001991","article-title":"A different form of injury prevention: Successful screening and referral for human immunodeficiency virus and hepatitis C virus in a trauma population","volume":"85","year":"2018","journal-title":"Journal of Trauma and Acute Care Surgery"},{"key":"2021081308150569000_2021.08.10.21261849v1.11","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/TA.0b013e31822178bd","article-title":"HIV and hepatitis in an urban penetrating trauma population: unrecognized and untreated","volume":"71","year":"2011","journal-title":"Journal of Trauma and Acute Care Surgery"},{"key":"2021081308150569000_2021.08.10.21261849v1.12","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1089\/sur.2010.074","article-title":"Pre-hospital intubation factors and pneumonia in trauma patients","volume":"12","year":"2011","journal-title":"Surg Infect (Larchmt)"},{"key":"2021081308150569000_2021.08.10.21261849v1.13","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1097\/TA.0000000000002870","article-title":"Early comprehensive testing for COVID-19 is essential to protect trauma centers","volume":"89","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"2021081308150569000_2021.08.10.21261849v1.14","unstructured":"B.J. Maguire , B.J. O\u2019Neill , J. Scot Phelps , P.P.M. Maniscalco , D.R. Gerard and N.K.A. Handal : COVID-19 fatalities among EMS clinicians by EMSUKAdmin| Sep 24, 2020."},{"key":"2021081308150569000_2021.08.10.21261849v1.15","unstructured":"N.L.E.M. Fund: Law Enforcement Officers Fatalities Report. (2020)."},{"key":"2021081308150569000_2021.08.10.21261849v1.16","doi-asserted-by":"crossref","unstructured":"M.D. Weiden , R. Zeig-Owens , A. Singh , T. Schwartz , Y. Liu , B. Vaeth , A. Nolan , K.L. Cleven , K. Hurwitz and S. Beecher : Pre-COVID-19 lung function and other risk factors for severe COVID-19 in first responders. ERJ Open Research 7 (2021).","DOI":"10.1183\/23120541.00610-2020"},{"key":"2021081308150569000_2021.08.10.21261849v1.17","doi-asserted-by":"crossref","first-page":"223","DOI":"10.3138\/jammi-2020-0030","article-title":"Estimating the extent of asymptomatic COVID-19 and its potential for community transmission: systematic review and meta-analysis","volume":"5","year":"2020","journal-title":"Official Journal of the Association of Medical Microbiology and Infectious Disease Canada"},{"key":"2021081308150569000_2021.08.10.21261849v1.18","doi-asserted-by":"crossref","unstructured":"H. Kalish , C. Klumpp-Thomas , S. Hunsberger , H.A. Baus , M.P. Fay , N. Siripong , J. Wang , J. Hicks , J. Mehalko and J. Travers : Undiagnosed SARS-CoV-2 Seropositivity During the First Six Months of the COVID-19 Pandemic in the United States. Science Translational Medicine (2021).","DOI":"10.1126\/scitranslmed.abh3826"},{"key":"2021081308150569000_2021.08.10.21261849v1.19","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1038\/s41467-020-20383-x","article-title":"Standardization of ELISA protocols for serosurveys of the SARS-CoV-2 pandemic using clinical and at-home blood sampling","volume":"12","year":"2021","journal-title":"Nature Communications"},{"key":"2021081308150569000_2021.08.10.21261849v1.20","doi-asserted-by":"crossref","unstructured":"D. Esposito , J. Mehalko , M. Drew , K. Snead , V. Wall , T. Taylor , P. Frank , J.-P. Denson , M. Hong and G. Gulten : Optimizing high-yield production of SARS-CoV-2 soluble spike trimers for serology assays. Protein Expression and Purification, 105686 (2020).","DOI":"10.1016\/j.pep.2020.105686"},{"key":"2021081308150569000_2021.08.10.21261849v1.21","doi-asserted-by":"crossref","unstructured":"J. Mehalko , M. Drew , K. Snead , J.-P. Denson , V. Wall , T. Taylor , K. Sadtler , S. Messing , W. Gillette and D. Esposito : Improved production of SARS-CoV-2 spike receptor-binding domain (RBD) for serology assays. Protein expression and purification, 105802 (2020).","DOI":"10.1101\/2020.11.18.388868"},{"key":"2021081308150569000_2021.08.10.21261849v1.22","unstructured":"O.o.B.S. Research : Update to spe-cial reports on traffic safety during the COVID-19 public health emergency: Fourth quarter dat, (National Highway Traffic Safety Administration 2021)."},{"key":"2021081308150569000_2021.08.10.21261849v1.23","unstructured":"F.D. Thomas , A. Berning , J. Darrah , L.A. Graham , R.D. Blomberg , C. Griggs , M. Crandall , C. Schulman , R. Kozar and M. Neavyn : Drug and Alcohol Prevalence in Seriously and Fatally Injured Road Users Before and During the COVID-19 Public Health Emergency, (United States. National Highway Traffic Safety Administration. Office of \u2026 2020)."},{"key":"2021081308150569000_2021.08.10.21261849v1.24","unstructured":"E. Wagner , R.G. Atkins , A. Berning , A. Robbins , C. Watson and J. Anderle : Examination of the Traffic Safety Environment During the Second Quarter of 2020: Special Report, (United States. National Highway Traffic Safety Administration. Office of \u2026 2020)."},{"key":"2021081308150569000_2021.08.10.21261849v1.25","doi-asserted-by":"crossref","unstructured":"J. Hicks , C. Klumpp-Thomas , H. Kalish , A. Shunmugavel , J. Mehalko , J.-P. Denson , K.R. Snead , M. Drew , K.S. Corbett and B.S. Graham : Serologic cross-reactivity of SARS-CoV-2 with endemic and seasonal Betacoronaviruses. Journal of clinical immunology, 1 (2021).","DOI":"10.1101\/2020.06.22.20137695"},{"key":"2021081308150569000_2021.08.10.21261849v1.26","unstructured":"C. Klumpp-Thomas , H. Kalish , J. Hicks , J. Mehalko , M. Drew , M.J. Memoli , M.D. Hall , D. Esposito and K. Sadtler : D614G Spike Variant Does Not Alter IgG, IgM, or IgA Spike Seroassay Performance. The Journal of Infectious Diseases (2020)."},{"key":"2021081308150569000_2021.08.10.21261849v1.27","unstructured":"M. Ploner : logistf: Firth\u2019s bias reduced logistic regression. R package version 1.10. http:\/\/CRAN. R-project. org\/package= logistf (2010)."},{"key":"2021081308150569000_2021.08.10.21261849v1.28","unstructured":"R.C. Team: R: A language and environment for statistical computing. (2013)."},{"key":"2021081308150569000_2021.08.10.21261849v1.29","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1097\/TA.0000000000002870","article-title":"Early comprehensive testing for COVID-19 is essential to protect trauma centers","volume":"89","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"2021081308150569000_2021.08.10.21261849v1.30","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1016\/S0140-6736(14)60687-5","article-title":"The systemic immune response to trauma: an overview of pathophysiology and treatment","volume":"384","year":"2014","journal-title":"The Lancet"},{"key":"2021081308150569000_2021.08.10.21261849v1.31","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1016\/S0140-6736(20)32009-2","article-title":"Prevalence of SARS-CoV-2 antibodies in a large nationwide sample of patients on dialysis in the USA: a cross-sectional study","volume":"396","year":"2020","journal-title":"The Lancet"},{"key":"2021081308150569000_2021.08.10.21261849v1.32","doi-asserted-by":"crossref","unstructured":"K.L. Bajema , R.E. Wiegand , K. Cuffe , S.V. Patel , R. Iachan , T. Lim , A. Lee , D. Moyse , F.P. Havers and L. Harding : Estimated SARS-CoV-2 Seroprevalence in the US as of September 2020. JAMA internal medicine (2020).","DOI":"10.1001\/jamainternmed.2020.7976"},{"key":"2021081308150569000_2021.08.10.21261849v1.33","doi-asserted-by":"crossref","first-page":"965","DOI":"10.15585\/mmwr.mm6929e2","article-title":"Estimated community seroprevalence of SARS-CoV-2 antibodies\u2014two Georgia counties, April 28\u2013May 3, 2020","volume":"69","year":"2020","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"2021081308150569000_2021.08.10.21261849v1.34","doi-asserted-by":"crossref","unstructured":"M.L. Dietrich , E.B. Norton , D. Elliott , A.R. Smira , J.A. Rouelle , N.G. Bond , K. Aime-Marcelin , A. Prystowsky , R. Kemnitz and A. Sarma : SARS-CoV-2 Seroprevalence Rates of Children in Louisiana During the State Stay at Home Order. medRxiv (2020).","DOI":"10.1101\/2020.07.07.20147884"},{"key":"2021081308150569000_2021.08.10.21261849v1.35","doi-asserted-by":"crossref","first-page":"2765","DOI":"10.3201\/eid2611.203029","article-title":"Seroprevalence of SARS-CoV-2 and infection fatality ratio, Orleans and Jefferson Parishes, Louisiana, USA, May 2020","volume":"26","year":"2020","journal-title":"Emerging infectious diseases"},{"key":"2021081308150569000_2021.08.10.21261849v1.36","first-page":"1576","article-title":"Seroprevalence of antibodies to SARS-CoV-2 in 10 sites in the United States, March 23-May 12, 2020","volume":"180","year":"2020","journal-title":"JAMA"},{"key":"2021081308150569000_2021.08.10.21261849v1.37","unstructured":"C.C. McLaughlin , M.K. Doll , K.T. Morrison , W.L. McLaughlin , T. O\u2019Connor , A.M. Sholukh , E.L. Bossard , K. Phasouk , E.S. Ford and K. Diem : High community SARS-CoV-2 antibody seroprevalence in a ski resort community, Blaine County, Idaho, US. preliminary results. Medrxiv (2020)."},{"key":"2021081308150569000_2021.08.10.21261849v1.38","first-page":"1","article-title":"SARS-CoV-2 seroprevalence and neutralizing activity in donor and patient blood","volume":"11","year":"2020","journal-title":"Nature communications"},{"key":"2021081308150569000_2021.08.10.21261849v1.39","unstructured":"T. Snyder , J. Ravenhurst , E.Y. Cramer , N. Reich , L.B. Balzer , D. Alfandari and A.A. Lover : Serological surveys to estimate cumulative incidence of SARS-CoV-2 infection in adults (Sero-MAss study), Massachusetts, July-August 2020-a mail-based cross-sectional study. medRxiv (2021)."},{"key":"2021081308150569000_2021.08.10.21261849v1.40","unstructured":"N. Sood , P. Simon , P. Ebner , D. Eichner , J. Reynolds , E. Bendavid and J. Bhattacharya : Seroprevalence of SARS-CoV-2\u2013Specific Antibodies Among Adults in Los Angeles County, California, on April 10-11, 2020. Jama (2020)."},{"key":"2021081308150569000_2021.08.10.21261849v1.41","doi-asserted-by":"crossref","first-page":"e2033706","DOI":"10.1001\/jamanetworkopen.2020.33706","article-title":"Estimation of US SARS-CoV-2 infections, symptomatic infections, hospitalizations, and deaths using seroprevalence surveys","volume":"4","year":"2021","journal-title":"JAMA network open"},{"key":"2021081308150569000_2021.08.10.21261849v1.42","first-page":"472","article-title":"Acute effect of lorazepam on respiratory muscles in stable patients with chronic obstructive pulmonary disease","volume":"56","year":"1996","journal-title":"Medicina"},{"key":"2021081308150569000_2021.08.10.21261849v1.43","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199601000-00004"},{"key":"2021081308150569000_2021.08.10.21261849v1.44","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318184821d"},{"key":"2021081308150569000_2021.08.10.21261849v1.45","doi-asserted-by":"crossref","first-page":"e0249271","DOI":"10.1371\/journal.pone.0249271","article-title":"Population density and basic reproductive number of COVID-19 across United States counties","volume":"16","year":"2021","journal-title":"PloS one"},{"key":"2021081308150569000_2021.08.10.21261849v1.46","first-page":"1","article-title":"Spatially adjusted time-varying reproductive numbers: understanding the geographical expansion of urban dengue outbreaks","volume":"9","year":"2019","journal-title":"Scientific reports"},{"key":"2021081308150569000_2021.08.10.21261849v1.47","unstructured":"S.N. Bleich and J.D. Ard : COVID-19, obesity, and structural racism: Understanding the past and identifying solutions for the future. Cell metabolism (2021)."}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2021.08.10.21261849","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T14:22:14Z","timestamp":1768486934000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2021.08.10.21261849"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,11]]},"references-count":47,"URL":"https:\/\/doi.org\/10.1101\/2021.08.10.21261849","relation":{},"subject":[],"published":{"date-parts":[[2021,8,11]]},"subtype":"preprint"}}