We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Performance of and Severe Acute Respiratory Syndrome Coronavirus 2 Diagnostics Based on Symptom Onset and Close Contact Exposure: An Analysis From the Test Us at Home Prospective Cohort Study.
- Authors
Herbert, Carly; Wang, Biqi; Lin, Honghuang; Yan, Yi; Hafer, Nathaniel; Pretz, Caitlin; Stamegna, Pamela; Wright, Colton; Suvarna, Thejas; Harman, Emma; Schrader, Summer; Nowak, Chris; Kheterpal, Vik; Orvek, Elizabeth; Wong, Steven; Zai, Adrian; Barton, Bruce; Gerber, Ben S; Lemon, Stephenie C; Filippaios, Andreas
- Abstract
Background Understanding changes in diagnostic performance after symptom onset and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure within different populations is crucial to guide the use of diagnostics for SARS-CoV-2. Methods The Test Us at Home study was a longitudinal cohort study that enrolled individuals across the United States between October 2021 and February 2022. Participants performed paired antigen-detection rapid diagnostic tests (Ag-RDTs) and reverse-transcriptase polymerase chain reaction (RT-PCR) tests at home every 48 hours for 15 days and self-reported symptoms and known coronavirus disease 2019 exposures immediately before testing. The percent positivity for Ag-RDTs and RT-PCR tests was calculated each day after symptom onset and exposure and stratified by vaccination status, variant, age category, and sex. Results The highest percent positivity occurred 2 days after symptom onset (RT-PCR, 91.2%; Ag-RDT, 71.1%) and 6 days after exposure (RT-PCR, 91.8%; Ag-RDT, 86.2%). RT-PCR and Ag-RDT performance did not differ by vaccination status, variant, age category, or sex. The percent positivity for Ag-RDTs was lower among exposed, asymptomatic than among symptomatic individuals (37.5% (95% confidence interval [CI], 13.7%–69.4%) vs 90.3% (75.1%–96.7%). Cumulatively, Ag-RDTs detected 84.9% (95% CI, 78.2%–89.8%) of infections within 4 days of symptom onset. For exposed participants, Ag-RDTs detected 94.0% (95% CI, 86.7%–97.4%) of RT-PCR–confirmed infections within 6 days of exposure. Conclusions The percent positivity for Ag-RDTs and RT-PCR tests was highest 2 days after symptom onset and 6 days after exposure, and performance increased with serial testing. The percent positivity of Ag-RDTs was lowest among asymptomatic individuals but did not differ by sex, variant, vaccination status, or age category.
- Subjects
UNITED States; SARS-CoV-2; CORONAVIRUS diseases; COVID-19; RAPID diagnostic tests; POLYMERASE chain reaction
- Publication
Open Forum Infectious Diseases, 2024, Vol 11, Issue 6, p1
- ISSN
2328-8957
- Publication type
Article
- DOI
10.1093/ofid/ofae304