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dc.contributor.authorHerbert, Carly
dc.contributor.authorWang, Biqi
dc.contributor.authorLin, Honghuang
dc.contributor.authorHafer, Nathaniel
dc.contributor.authorPretz, Caitlin
dc.contributor.authorStamegna, Pamela
dc.contributor.authorTarrant, Seanan
dc.contributor.authorHartin, Paul
dc.contributor.authorFerranto, Julia
dc.contributor.authorBehar, Stephanie
dc.contributor.authorWright, Colton
dc.contributor.authorOrwig, Taylor
dc.contributor.authorSuvarna, Thejas
dc.contributor.authorHarman, Emma
dc.contributor.authorSchrader, Summer
dc.contributor.authorNowak, Chris
dc.contributor.authorKheterpal, Vik
dc.contributor.authorOrvek, Elizabeth
dc.contributor.authorWong, Steven
dc.contributor.authorZai, Adrian
dc.contributor.authorBarton, Bruce
dc.contributor.authorGerber, Ben S
dc.contributor.authorLemon, Stephenie C
dc.contributor.authorFilippaios, Andreas
dc.contributor.authorD'Amore, Kylie
dc.contributor.authorGibson, Laura
dc.contributor.authorGreene, Sharone
dc.contributor.authorHoward-Wilson, Sakeina
dc.contributor.authorColubri, Andres
dc.contributor.authorAchenbach, Chad
dc.contributor.authorMurphy, Robert
dc.contributor.authorHeetderks, William
dc.contributor.authorManabe, Yukari C
dc.contributor.authorO'Connor, Laurel
dc.contributor.authorFahey, Nisha
dc.contributor.authorLuzuriaga, Katherine
dc.contributor.authorBroach, John
dc.contributor.authorMcManus, David D
dc.contributor.authorSoni, Apurv
dc.date.accessioned2023-03-14T14:02:26Z
dc.date.available2023-03-14T14:02:26Z
dc.date.issued2023-02-24
dc.identifier.citationHerbert C, Wang B, Lin H, Hafer N, Pretz C, Stamegna P, Tarrant S, Hartin P, Ferranto J, Behar S, Wright C, Orwig T, Suvarna T, Harman E, Schrader S, Nowak C, Kheterpal V, Orvek E, Wong S, Zai A, Barton B, Gerber B, Lemon SC, Filippaios A, D'Amore K, Gibson L, Greene S, Howard-Wilson S, Colubri A, Achenbach C, Murphy R, Heetderks W, Manabe YC, O'Connor L, Fahey N, Luzuriaga K, Broach J, McManus DD, Soni A. Performance of Rapid Antigen Tests Based on Symptom Onset and Close Contact Exposure: A secondary analysis from the Test Us At Home prospective cohort study. medRxiv [Preprint]. 2023 Feb 24:2023.02.21.23286239. doi: 10.1101/2023.02.21.23286239. PMID: 36865199; PMCID: PMC9980261.en_US
dc.identifier.doi10.1101/2023.02.21.23286239en_US
dc.identifier.pmid36865199
dc.identifier.urihttp://hdl.handle.net/20.500.14038/51804
dc.descriptionThis article is a preprint. Preprints are preliminary reports of work that have not been certified by peer review.en_US
dc.description.abstractBackground: The performance of rapid antigen tests for SARS-CoV-2 (Ag-RDT) in temporal relation to symptom onset or exposure is unknown, as is the impact of vaccination on this relationship. Objective: To evaluate the performance of Ag-RDT compared with RT-PCR based on day after symptom onset or exposure in order to decide on 'when to test'. Design setting and participants: The Test Us at Home study was a longitudinal cohort study that enrolled participants over 2 years old across the United States between October 18, 2021 and February 4, 2022. All participants were asked to conduct Ag-RDT and RT-PCR testing every 48 hours over a 15-day period. Participants with one or more symptoms during the study period were included in the Day Post Symptom Onset (DPSO) analyses, while those who reported a COVID-19 exposure were included in the Day Post Exposure (DPE) analysis. Exposure: Participants were asked to self-report any symptoms or known exposures to SARS-CoV-2 every 48-hours, immediately prior to conducting Ag-RDT and RT-PCR testing. The first day a participant reported one or more symptoms was termed DPSO 0, and the day of exposure was DPE 0. Vaccination status was self-reported. Main outcome and measures: Results of Ag-RDT were self-reported (positive, negative, or invalid) and RT-PCR results were analyzed by a central laboratory. Percent positivity of SARS-CoV-2 and sensitivity of Ag-RDT and RT-PCR by DPSO and DPE were stratified by vaccination status and calculated with 95% confidence intervals. Results: A total of 7,361 participants enrolled in the study. Among them, 2,086 (28.3%) and 546 (7.4%) participants were eligible for the DPSO and DPE analyses, respectively. Unvaccinated participants were nearly twice as likely to test positive for SARS-CoV-2 than vaccinated participants in event of symptoms (PCR+: 27.6% vs 10.1%) or exposure (PCR+: 43.8% vs. 22.2%). The highest proportion of vaccinated and unvaccinated individuals tested positive on DPSO 2 and DPE 5-8. Performance of RT-PCR and Ag-RDT did not differ by vaccination status. Ag-RDT detected 78.0% (95% Confidence Interval: 72.56-82.61) of PCR-confirmed infections by DPSO 4. For exposed participants, Ag-RDT detected 84.9% (95% CI: 75.0-91.4) of PCR-confirmed infections by day five post-exposure (DPE 5). Conclusions and relevance: Performance of Ag-RDT and RT-PCR was highest on DPSO 0-2 and DPE 5 and did not differ by vaccination status. These data suggests that serial testing remains integral to enhancing the performance of Ag-RDT.en_US
dc.description.sponsorshipThis study was funded by the NIH RADx Tech program under 3U54HL143541-02S2 and NIH CTSA grant UL1TR001453. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Institute of Biomedical Imaging and Bioengineering; the National Heart, Lung, and Blood Institute; the National Institutes of Health, or the U.S. Department of Health and Human Services. Salary support from the National Institutes of Health U54HL143541, R01HL141434, R01HL137794, R61HL158541, R01HL137734, U01HL146382 (AS, DDM), U01AG068221 (HL), U54EB007958-13 (YCM, MLR), AI272201400007C, UM1AI068613 (YCM), U54EB027049 and U54EB027049-02S1 (CJA, RLM).en_US
dc.language.isoenen_US
dc.relation.ispartofmedRxiven_US
dc.relation.urlhttps://doi.org/10.1101/2023.02.21.23286239en_US
dc.rightsThe copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission.en_US
dc.subjectSARS-CoV-2en_US
dc.subjectrapid antigen testsen_US
dc.subjectsymptomsen_US
dc.subjectclose contact exposureen_US
dc.subjectUMCCTS fundingen_US
dc.titlePerformance of Rapid Antigen Tests Based on Symptom Onset and Close Contact Exposure: A secondary analysis from the Test Us At Home prospective cohort study [preprint]en_US
dc.typePreprinten_US
dc.source.journaltitlemedRxiv : the preprint server for health sciences
dc.source.countryUnited States
dc.identifier.journalmedRxiv : the preprint server for health sciences
dc.contributor.departmentCenter for Clinical and Translational Scienceen_US
dc.contributor.departmentEmergency Medicineen_US
dc.contributor.departmentMedicineen_US
dc.contributor.departmentMicrobiology and Physiological Systemsen_US
dc.contributor.departmentMorningside Graduate School of Biomedical Sciencesen_US
dc.contributor.departmentPediatricsen_US
dc.contributor.departmentPopulation and Quantitative Health Sciencesen_US
dc.contributor.departmentProgram in Molecular Medicineen_US
dc.contributor.departmentPrevention Research Centeren_US
dc.contributor.departmentBiostatistics and Health Services Researchen_US
dc.contributor.studentCarly Herbert


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