Observational studyBMC infectious diseases2025
Changing epidemiology of SARS-CoV-2 positivity rates in a diverse population of children and adults during variant evolution and progressive vaccination eligibility in New York City.
Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe COVID-19 pandemic resulted in multiple waves of infections in New York City, driven by evolving SARS-CoV-2 variants and shifting vaccine eligibility. We describe the trends in SARS-CoV-2 epidemiology in adults and children over consecutive waves during the height of the COVID-19 pandemic in New York City.
methodsA retrospective observational cohort study was performed in adults and children who were tested for SARS-CoV-2 by PCR in a multi-hospital network in New York City from 10/1/2020 to 9/19/2022. Positivity rates and vaccination rates were determined over multiple waves of infections. A subset of nasopharyngeal specimens underwent whole genome sequencing to determine the SARS-CoV-2 variant distribution in adults and children.
resultsThere were 243,457 SARS-CoV-2 PCR tests performed in adults (89.2%) and 29,333 in children (10.8%) with overall positivity rates of 6.2% in adults and 5.9% in children during the study period. The highest overall positivity rate (12.1%) was seen during Wave 4 when the Omicron variant was predominant and positivity rates in children surpassed those in adults for the first time (children 15.6%, adults 11.7%, p < 0.001). During Wave 4, SARS-CoV-2 positivity was associated with pediatric age (aOR 1.13, 95% CI 1.02, 1.25), non-White race (aOR 1.36, 95% CI 1.26, 1.47), Hispanic ethnicity (aOR 1.53, 95% CI 1.38, 1.69), and unvaccinated status (aOR 1.48, 95% CI 1.38, 1.58). SARS-CoV-2 variant distribution did not differ over time between adults and children.
conclusionsOur large cohort of SARS-CoV-2 PCR testing over multiple COVID-19 waves in New York City demonstrated a shift in positivity rates when the Omicron variant was predominant, with disproportionate positivity in children, unvaccinated individuals, and specific racial and ethnic groups. As vaccination rates decline in response to changes in vaccine recommendations, this scenario may recur with the emergence of a new virulent SARS-CoV-2 variant or re-emergence of vaccine-preventable diseases. These findings highlight the need for targeted public health strategies that prioritize vulnerable populations during respiratory viral surges. CLINICAL TRIAL: Not applicable.
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