tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2024 May 31;11(6)
fae304.
doi: 10.1093/ofid/ofae304. eCollection 2024 Jun. 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
Carly Herbert[SUP] 1 2 [/SUP], Biqi Wang[SUP] 1 3 [/SUP], Honghuang Lin[SUP] 1 3 [/SUP], Yi Yan[SUP] 4 [/SUP], Nathaniel Hafer[SUP] 2 5 [/SUP], Caitlin Pretz[SUP] 1 [/SUP], Pamela Stamegna[SUP] 1 [/SUP], Colton Wright[SUP] 1 [/SUP], Thejas Suvarna[SUP] 6 [/SUP], Emma Harman[SUP] 6 [/SUP], Summer Schrader[SUP] 6 [/SUP], Chris Nowak[SUP] 6 [/SUP], Vik Kheterpal[SUP] 6 [/SUP], Elizabeth Orvek[SUP] 7 [/SUP], Steven Wong[SUP] 7 [/SUP], Adrian Zai[SUP] 7 [/SUP], Bruce Barton[SUP] 7 [/SUP], Ben S Gerber[SUP] 7 [/SUP], Stephenie C Lemon[SUP] 7 [/SUP], Andreas Filippaios[SUP] 1 [/SUP], Laura Gibson[SUP] 8 [/SUP], Sharone Greene[SUP] 8 [/SUP], Andres Colubri[SUP] 9 [/SUP], Chad Achenbach[SUP] 10 [/SUP], Robert Murphy[SUP] 10 [/SUP], William Heetderks[SUP] 11 [/SUP], Yukari C Manabe[SUP] 12 [/SUP], Laurel O'Connor[SUP] 13 [/SUP], Nisha Fahey[SUP] 1 7 14 [/SUP], Katherine Luzuriaga[SUP] 2 5 [/SUP], John Broach[SUP] 2 13 [/SUP], Kristian Roth[SUP] 4 [/SUP], David D McManus[SUP] 1 3 15 [/SUP], Apurv Soni[SUP] 1 3 7 [/SUP]
Affiliations
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.
Keywords: COVID-19; RT-PCR; SARS-CoV-2; SARS-CoV-2 variant; rapid antigen test.
. 2024 May 31;11(6)
fae304.doi: 10.1093/ofid/ofae304. eCollection 2024 Jun. 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
Carly Herbert[SUP] 1 2 [/SUP], Biqi Wang[SUP] 1 3 [/SUP], Honghuang Lin[SUP] 1 3 [/SUP], Yi Yan[SUP] 4 [/SUP], Nathaniel Hafer[SUP] 2 5 [/SUP], Caitlin Pretz[SUP] 1 [/SUP], Pamela Stamegna[SUP] 1 [/SUP], Colton Wright[SUP] 1 [/SUP], Thejas Suvarna[SUP] 6 [/SUP], Emma Harman[SUP] 6 [/SUP], Summer Schrader[SUP] 6 [/SUP], Chris Nowak[SUP] 6 [/SUP], Vik Kheterpal[SUP] 6 [/SUP], Elizabeth Orvek[SUP] 7 [/SUP], Steven Wong[SUP] 7 [/SUP], Adrian Zai[SUP] 7 [/SUP], Bruce Barton[SUP] 7 [/SUP], Ben S Gerber[SUP] 7 [/SUP], Stephenie C Lemon[SUP] 7 [/SUP], Andreas Filippaios[SUP] 1 [/SUP], Laura Gibson[SUP] 8 [/SUP], Sharone Greene[SUP] 8 [/SUP], Andres Colubri[SUP] 9 [/SUP], Chad Achenbach[SUP] 10 [/SUP], Robert Murphy[SUP] 10 [/SUP], William Heetderks[SUP] 11 [/SUP], Yukari C Manabe[SUP] 12 [/SUP], Laurel O'Connor[SUP] 13 [/SUP], Nisha Fahey[SUP] 1 7 14 [/SUP], Katherine Luzuriaga[SUP] 2 5 [/SUP], John Broach[SUP] 2 13 [/SUP], Kristian Roth[SUP] 4 [/SUP], David D McManus[SUP] 1 3 15 [/SUP], Apurv Soni[SUP] 1 3 7 [/SUP]
Affiliations
- PMID: 38911947
- PMCID: PMC11191649
- DOI: 10.1093/ofid/ofae304
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.
Keywords: COVID-19; RT-PCR; SARS-CoV-2; SARS-CoV-2 variant; rapid antigen test.