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. 2022 Oct 3;5(10):e2237149.
doi: 10.1001/jamanetworkopen.2022.37149.

Prevalence of Positive Rapid Antigen Tests After 7-Day Isolation Following SARS-CoV-2 Infection in College Athletes During Omicron Variant Predominance

Jessica Tsao  1 , Andrea Kussman  1 , Nicole A Segovia  1 , Geoffrey D Abrams  1 , Alexandria B Boehm  2 , Calvin E Hwang  1
Affiliations

Prevalence of Positive Rapid Antigen Tests After 7-Day Isolation Following SARS-CoV-2 Infection in College Athletes During Omicron Variant Predominance

Jessica Tsao et al. JAMA Netw Open. .

Abstract

Importance: 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.

Objective: 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.

Exposures: Rapid antigen testing 7 days after testing positive for SARS-CoV-2.

Main outcomes and measures: Rapid antigen test results, symptom status, and SARS-CoV-2 variant identification via campus wastewater analysis.

Results: 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).

Conclusions and relevance: 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.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Kussman reported receiving speaking fees from Fresno Madera Medical Society outside the submitted work. Dr Abrams reported owning stock or stock options from AxGen and Cytonics; serving as an unpaid board or committee member for the American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine; receiving cadaver instruction and equipment for educational purposes from Arthrex and Stryker; receiving consulting fees from Bioventus Inc, Cytonics, Fidia Pharma, and RubiconMD; and serving as an unpaid consultant for TeachAids. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Flow Diagram of Antigen Test Results
Test results of all 268 cases included in the cohort.
Figure 2.
Figure 2.. Proportion of Participants With Positive Results for SARS-CoV-2 After 7-Day Isolation Period
The shaded area represents 95% CIs.
See this image and copyright information in PMC

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