Looking for Antibodies to COVID-19 Among the Deceased

In 2020, Associate Professor Keri Althoff set out to measure antibodies to the COVID-19 virus among the deceased examined by the Maryland Office of the Chief Medical Examiner over 6 months before vaccines were available. She also wanted to determine if the increased antibody prevalence associated with motor vehicle crashes and decreased prevalence associated with illicit drug overdose persisted through November 2020. 

1,906 decedents were included in the study.  Non- Hispanic Blacks, Hispanics, and those aged 18–64 years were overrepresented compared to the general population.  

The team found:  

• Hispanic men and women had a much higher prevalence of antibodies compared to their White and Black counterparts. Antibody prevalence was highest among those dying in a motor vehicle crash. These findings could be attributed to occupational exposure, as Hispanics were overrepresented in essential work, and essential workers continued driving to commute. This builds on the evidence that this could be a sentinel surveillance population in cases of new emerging infectious pathogens.  
• Prevalence among those who died of illicit drug overdose was initially lower than for nonoverdose deaths in May-July, but this changed in August 2020. By November 2020, prevalence by overdose status was comparable. 

This study demonstrates how readily available, cost-effective data can be leveraged to provide real-time information on potential signals of infectious disease spread. The researchers encourage further exploration of this approach for potential sentinel surveillance to other states and regions in the US as COVID-19 and future pandemic preparedness remains an enduring public health priority.  

These findings were highlighted in The Baltimore Sun in December 2020 and published in Open Forum Infectious Diseases in January 2021 and in May 2022.