Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California.
Department of Civil & Environmental Engineering, Stanford University, Stanford, California.
JAMA Netw Open. 2022 Oct 3;5(10):e2237149. doi: 10.1001/jamanetworkopen.2022.37149.
The US Centers for Disease Control and Prevention shortened the recommended isolation period for SARS-CoV-2 infection from 10 days to 5 days in December 2021. It is unknown whether an individual with the infection may still have a positive result to a rapid antigen test and potentially be contagious at the end of this shortened isolation period.
To estimate the proportion of individuals with SARS-CoV-2 infection whose rapid antigen test is still positive starting 7 days postdiagnosis.
DESIGN, SETTING, AND PARTICIPANTS: This case series analyzed student athletes at a National Collegiate Athletic Association Division I university campus who tested positive for SARS-CoV-2 between January 3 and May 6, 2022. Individuals underwent rapid antigen testing starting 7 days postdiagnosis to determine whether they could end their isolation period.
Rapid antigen testing 7 days after testing positive for SARS-CoV-2.
Rapid antigen test results, symptom status, and SARS-CoV-2 variant identification via campus wastewater analysis.
A total of 264 student athletes (140 [53%] female; mean [SD] age, 20.1 [1.2] years; range, 18-25 years) representing 268 infections (177 [66%] symptomatic, 91 [34%] asymptomatic) were included in the study. Of the 248 infections in individuals who did a day 7 test, 67 (27%; 95% CI, 21%-33%) tests were still positive. Patients with symptomatic infections were significantly more likely to test positive on day 7 vs those who were asymptomatic (35%; 95% CI, 28%-43% vs 11%; 95% CI, 5%-18%; P < .001). Patients with the BA.2 variant were also significantly more likely to test positive on day 7 compared with those with the BA.1 variant (40%; 95% CI, 29%-51% vs 21%; 95% CI, 15%-27%; P = .007).
In this case series, rapid antigen tests remained positive in 27% of the individuals after 7 days of isolation, suggesting that the Centers for Disease Control and Prevention-recommended 5-day isolation period may be insufficient in preventing ongoing spread of disease. Further studies are needed to determine whether these findings are present in a more heterogeneous population and in subsequent variants.
美国疾病控制与预防中心（CDC）于 2021 年 12 月将 SARS-CoV-2 感染的建议隔离期从 10 天缩短至 5 天。目前尚不清楚在缩短的隔离期结束时，感染 SARS-CoV-2 的个体的快速抗原检测结果是否仍为阳性，以及是否仍具有传染性。
估计 SARS-CoV-2 感染个体在诊断后 7 天开始时快速抗原检测仍呈阳性的比例。
设计、地点和参与者：这项病例系列分析了美国全国大学体育协会（NCAA）一级大学校园中于 2022 年 1 月 3 日至 5 月 6 日检测出 SARS-CoV-2 呈阳性的学生运动员。个体在诊断后 7 天开始进行快速抗原检测，以确定是否可以结束隔离期。
SARS-CoV-2 检测呈阳性后 7 天进行快速抗原检测。
快速抗原检测结果、症状状态以及通过校园废水分析确定 SARS-CoV-2 变体。
共有 264 名学生运动员（140 名[53%]女性；平均[标准差]年龄 20.1[1.2]岁；范围 18-25 岁）代表 268 例感染（177 例[66%]有症状，91 例[34%]无症状）被纳入研究。在进行第 7 天检测的 248 例感染中，有 67 例（27%；95%CI，21%-33%）检测结果仍为阳性。与无症状感染者相比，有症状感染者在第 7 天检测呈阳性的可能性显著更高（35%；95%CI，28%-43%比 11%；95%CI，5%-18%；P<0.001）。与 BA.1 变体相比，BA.2 变体患者在第 7 天检测呈阳性的可能性也显著更高（40%；95%CI，29%-51%比 21%；95%CI，15%-27%；P=0.007）。
在这项病例系列研究中，在隔离 7 天后，快速抗原检测仍呈阳性的个体占 27%，这表明 CDC 推荐的 5 天隔离期可能不足以防止疾病的持续传播。需要进一步研究以确定这些发现是否存在于更具异质性的人群中和随后的变体中。
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