{"doi":"10.1093/ofid/ofae304","title":"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","abstract":"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.","journal":"Open Forum Infectious Diseases","year":2024,"id":480286,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8161,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":796321,"name":"Biqi Wang","orcid":"0000-0001-9062-5677","position":1,"is_corresponding":false},{"id":24806,"name":"Honghuang Lin","orcid":"0000-0003-3043-3942","position":2,"is_corresponding":false},{"id":984328,"name":"Yan Yi","orcid":"0000-0001-8718-0451","position":3,"is_corresponding":false},{"id":371418,"name":"Nathaniel Hafer","orcid":"0000-0002-0164-5092","position":4,"is_corresponding":false},{"id":942386,"name":"Caitlin Pretz","orcid":"0000-0002-5272-003X","position":5,"is_corresponding":false},{"id":983988,"name":"Pamela Stamegna","orcid":null,"position":6,"is_corresponding":false},{"id":983576,"name":"Colton Wright","orcid":"0000-0003-2399-1815","position":7,"is_corresponding":false},{"id":915507,"name":"Thejas Suvarna","orcid":"0000-0002-4811-0298","position":8,"is_corresponding":false},{"id":301093,"name":"Emma Harman","orcid":"0000-0002-8006-560X","position":9,"is_corresponding":false},{"id":915508,"name":"Summer Schrader","orcid":"0000-0002-5678-8613","position":10,"is_corresponding":false},{"id":942388,"name":"Christopher Nowak","orcid":"0000-0003-1796-9558","position":11,"is_corresponding":false},{"id":227521,"name":"Vik Kheterpal","orcid":"0000-0002-4752-4229","position":12,"is_corresponding":false},{"id":545672,"name":"Elizabeth Orvek","orcid":"0000-0001-6974-6263","position":13,"is_corresponding":false},{"id":42008,"name":"Steven Wong","orcid":null,"position":14,"is_corresponding":false},{"id":956597,"name":"Adrian Zai","orcid":"0000-0002-2972-6839","position":15,"is_corresponding":false},{"id":417373,"name":"Bruce Barton","orcid":"0000-0001-7878-8895","position":16,"is_corresponding":false},{"id":409588,"name":"Ben S. 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