Healthcare personnel frequently have positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen tests 5 days or more after diagnosis of coronavirus disease 2019 (COVID-19)

Stiefel, Usha; Bhullar, Davinder; Zabarsky, Trina F.; Palmieri, Natalie F; Diaz, Kimberly D; Torres-Teran, Maria M; Donskey, Curtis J.

doi:10.1017/ice.2022.21

Cited by 8 publications

(11 citation statements)

References 7 publications

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“…Of persons with COVID-19 re-testing on Day 5, 80% of symptomatic people and 41% of asymptomatic people remained positive. This number is nearly identical to a community-based sample of people seeking testing in Alaska 25 and similar to the findings in two cohorts of health care workers 26,27 . This high proportion of positive repeat tests is not surprising, given existing data on viral dynamics of Omicron and other variants.…”

Section: Discussionsupporting

confidence: 83%

COVID-19 symptoms and duration of direct antigen test positivity at a community testing and surveillance site, January 2021-2022

Marquez

Kerkhoff

Schrom

et al. 2022

Preprint

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Importance: Characterizing clinical symptoms and evolution of community- based SARS Co-V-2 infections can inform health practitioners and public health officials in a rapidly changing landscape of population immunity and viral variants. Objective: To characterize COVID-19 symptoms during the Omicron period compared to pre-Delta and Delta variant periods and assess the duration of COVID-19 BinaxNOW rapid antigen test positivity during the Omicron variant surge. Design, Setting, and Participants: This public health surveillance study was undertaken between January 2021- January 2022, at a walk-up community COVID-19 testing site in San Francisco, California. Testing with BinaxNOW rapid antigen tests was available regardless of age, vaccine status, or symptoms throughout. Main Outcomes and Measures: We characterized the prevalence of specific symptoms for people with a positive BinaxNOW test during the Omicron period and compared it to the pre-Delta and Delta periods. During the Omicron period, we examined differences in symptoms by age and vaccine status. Among people returning for repeat testing during Omicron period, we estimated the proportion with a positive BinaxNOW antigen test between 4-14 days from symptom onset or since first positive test if asymptomatic. Results: Of 63,277 persons tested, 18,301 (30%) reported symptoms and 4,568 (25%) tested positive for COVID-19. During the Omicron period, 41.6% (3032/7283) of symptomatic testers tested positive, and the proportion reporting cough (67.4%) and sore throat (43.4%) was higher than during Delta and pre-Delta periods. Congestion was higher during Omicron (38.8%) than during the pre-Delta period and loss of taste/smell (5.3%) and fever (30.4%) were less common. Fevers and myalgias were less common among persons who had received boosters compared to unvaccinated people or those who received the primary series. Five days after symptom onset, 31.1% of people with COVID-19 stated their symptoms were similar or worsening. An estimated 80.2% of symptomatic re-testers remained positive five days after symptom onset and 60.5% after ten days. Conclusions and Relevance: COVID-19 upper respiratory tract symptoms were more commonly reported during the Omicron period compared to pre-Delta and Delta periods, with differences by vaccination status. Antigen test positivity remained high after 5 days, supporting guidelines requiring a negative test to shorten the isolation period.

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Section: Discussionsupporting

confidence: 83%

COVID-19 symptoms and duration of direct antigen test positivity at a community testing and surveillance site, January 2021-2022

Marquez

Kerkhoff

Schrom

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…JAMA Network Open. 2022;5(10):e2235844. doi:10.1001/jamanetworkopen.2022.35844 (Reprinted) October 10, 2022 12/14 Downloaded From: https://jamanetwork.com/ on 10/16/2022…”

mentioning

confidence: 99%

COVID-19 Symptoms and Duration of Rapid Antigen Test Positivity at a Community Testing and Surveillance Site During Pre-Delta, Delta, and Omicron BA.1 Periods

et al. 2022

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ImportanceCharacterizing the clinical symptoms and evolution of community-based SARS-CoV-2 infections may inform health practitioners and public health officials in a rapidly changing landscape of population immunity and viral variants.ObjectivesTo compare COVID-19 symptoms among people testing positive with a rapid antigen test (RAT) during the Omicron BA.1 variant period (December 1, 2021, to January 30, 2022) with the pre-Delta (January 10 to May 31, 2021) and Delta (June 1 to November 30, 2021) variant periods and to assess the duration of RAT positivity during the Omicron BA.1 surge.Design, Setting, and ParticipantsThis cross-sectional study was conducted from January 10, 2021, to January 31, 2022, at a walk-up community COVID-19 testing site in San Francisco, California. Participants included children and adults seeking COVID-19 testing with an RAT, regardless of age, vaccine status, or symptoms.Main Outcomes and MeasuresFisher exact tests or χ2 tests were used to compare COVID-19 symptoms during the Omicron BA.1 period with the pre-Delta and Delta periods for vaccination status and age group. Among people returning for repeated testing during the Omicron period, the proportion with a positive RAT between 4 and 14 days from symptom onset or since first positive test if asymptomatic was estimated.ResultsAmong 63 277 persons tested (median [IQR] age, 32 [21-44] years, with 12.0% younger than 12 years; 52.0% women; and 68.5% Latinx), a total of 18 301 people (28.9%) reported symptoms, of whom 4565 (24.9%) tested positive for COVID-19. During the Omicron BA.1 period, 3032 of 7283 symptomatic participants (41.6%) tested positive, and the numbers of these reporting cough and sore throat were higher than during pre-Delta and Delta periods (cough: 2044 [67.4%] vs 546 [51.3%] of 1065 participants, P &lt; .001 for pre-Delta, and 281 [60.0%] of 468 participants, P = .002, for Delta; sore throat: 1316 [43.4%] vs 315 [29.6%] of 1065 participants, P &lt; .001 for pre-Delta, and 136 [29.1%] of 468 participants, P &lt; .001, for Delta). Compared with the 1065 patients with positive test results in the pre-Delta period, congestion among the 3032 with positive results during the Omicron BA.1 period was more common (1177 [38.8%] vs 294 [27.6%] participants, P &lt; .001), and loss of taste or smell (160 [5.3%] vs 183 [17.2%] participants, P &lt; .001) and fever (921 [30.4%] vs 369 [34.7%] participants, P = .01) were less common. In addition, during the Omicron BA.1 period, fever was less common among the people with positive test results who had received a vaccine booster compared with those with positive test results who were unvaccinated (97 [22.5%] of 432 vs 42 [36.2%] of 116 participants, P = .003), and fever and myalgia were less common among participants who had received a booster compared with those with positive results who had received only a primary series (fever: 97 [22.5%] of 432 vs 559 [32.8%] of 1705 participants, P &lt; .001; myalgia: 115 [26.6%] of 432 vs 580 [34.0%] of 1705 participants, P = .003). During the Omicron BA.1 period, 5 days after symptom onset, 507 of 1613 people (31.1%) with COVID-19 stated that their symptoms were similar, and 95 people (5.9%) reported worsening symptoms. Among people testing positive, 80.2% of participants who were symptomatic and retested remained positive 5 days after symptom onset.Conclusions and RelevanceIn this cross-sectional study, COVID-19 upper respiratory tract symptoms were more commonly reported during the Omicron BA.1 period than during the pre-Delta and Delta periods, with differences by vaccination status. Rapid antigen test positivity remained high 5 days after symptom onset, supporting guidelines requiring a negative test to inform the length of the isolation period.

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“…In one study among 290 HCWs, 49% of those testing on Day 5 after COVID-19 diagnosis were antigen positive and there was no difference among those unvaccinated compared to fully vaccinated and/or boosted. [11] In a larger sample of 1661 HCWs, 88.1% were antigen positive on Day 5 and antigen positivity was associated with symptomatic infections and vaccinations being up to date. [12] Our findings on antigen-positivity falls between these two prior reports and show that a majority of HCWs might continue to be infectious at 5 days.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with antigen test positivity following SARS-CoV-2 infection among healthcare workers in Los Angeles

Adamson

Currier

Uslan

et al. 2022

Preprint

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Surges of SARS-CoV-2 infections among healthcare workers (HCWs) have led to critical staffing shortages. From January 4 to February 4, 2022, we implemented a return-to-work antigen testing program for HCWs and 870 HCWs participated. Antigen test positivity was 60.5% for those ≤5 days from symptom onset or positive PCR and 47.4% were positive at day 7. Antigen positivity was associated with receiving a booster vaccination and being ≤6 days from symptom onset or PCR test, but not age or a symptomatic infection. Rapid antigen testing can be a useful tool to guide return-to-work and isolation precautions for HCWs following infection.

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Healthcare personnel frequently have positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen tests 5 days or more after diagnosis of coronavirus disease 2019 (COVID-19)

Cited by 8 publications

References 7 publications

COVID-19 symptoms and duration of direct antigen test positivity at a community testing and surveillance site, January 2021-2022

COVID-19 symptoms and duration of direct antigen test positivity at a community testing and surveillance site, January 2021-2022

COVID-19 Symptoms and Duration of Rapid Antigen Test Positivity at a Community Testing and Surveillance Site During Pre-Delta, Delta, and Omicron BA.1 Periods

Prevalence and factors associated with antigen test positivity following SARS-CoV-2 infection among healthcare workers in Los Angeles

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