Designing isolation guidelines for COVID-19 patients with rapid antigen tests

  1. Yong Dam Jeong
  2. Keisuke Ejima
  3. Kwang Su Kim
  4. Woo Joohyeon
  5. Shoya Iwanami
  6. Yasuhisa Fujita
  7. Il Hyo Jung
  8. Kazuyuki Aihara
  9. Kenji Shibuya
  10. Shingo Iwami
  11. Ana I. Bento
  12. Marco Ajelli

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Abstract

Appropriate isolation guidelines for COVID-19 patients are warranted. Currently, isolating for fixed time is adopted in most countries. However, given the variability in viral dynamics between patients, some patients may no longer be infectious by the end of isolation, whereas others may still be infectious. Utilizing viral test results to determine isolation length would minimize both the risk of prematurely ending isolation of infectious patients and the unnecessary individual burden of redundant isolation of noninfectious patients. In this study, we develop a data-driven computational framework to compute the population-level risk and the burden of different isolation guidelines with rapid antigen tests (i.e., lateral flow tests). Here, we show that when the detection limit is higher than the infectiousness threshold values, additional consecutive negative results are needed to ascertain infectiousness status. Further, rapid antigen tests should be designed to have lower detection limits than infectiousness threshold values to minimize the length of prolonged isolation.

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  1. Version published to 10.1038/s41467-022-32663-9
  2. ScreenIT

    SciScore for 10.1101/2022.01.24.22269769: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Viral load data: Longitudinal viral load data of symptomatic and asymptomatic COVID-19 patients were extracted from literatures using PubMed and Google Scholar.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Google Scholar
    suggested: (Google Scholar, RRID:SCR_008878)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    A limitation of this study is that the data used to calibrate the model refers to the original SARS-CoV-22 lineage. Previous studies suggest the viral dynamics are different between the original and the Delta variant (Li et al., 2021). Moreover, we do not have data to calibrate the model for vaccinated individuals, let alone with different vaccine types and number of doses, and previous studies have shown differences in the viral load of infected vaccinated vs. infected unvaccinated individuals (Chia et al.). The COVID-19 pandemic is having an unprecedented impact on the lives of nearly every human being on the planet and is still causing interruptions in educational and economic activities. Isolating infected individuals is still a key component of the pandemic response and development of appropriate isolation guidelines is needed. Our study provides insights on the use of rapid antigen tests to minimize both the burden of isolation and the risk of releasing infectious individuals, and suggest that different guidelines may be warranted for symptomatic and asymptomatic individuals.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.01.24.22269769 on medRxiv