Preliminary Research on a COVID-19 Test Strategy to Guide Quarantine Interval in University Students

  1. Jill M. Kolesar
  2. Tyler Gayheart
  3. Lance Poston
  4. Eric Monday
  5. Derek Forster
  6. Elizabeth Belcher
  7. Rani Jaiswal
  8. J. Kirsten Turner
  9. Donna K. Arnett
  10. Eric B. Durbin
  11. Joseph Monroe
  12. Frank Romanelli
  13. Susanne M. Arnold
  14. C. Darrell Jennings
  15. Heidi Weiss
  16. Robert DiPaola

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Abstract

Following COVID-19 exposure, the Centers for Disease Control (CDC) recommends a 10–14-day quarantine for asymptomatic individuals and more recently a 7-day quarantine with a negative PCR test. A university-based prospective cohort study to determine if early polymerase chain reaction (PCR) negativity predicts day 14 negativity was performed. A total of 741 asymptomatic students in quarantine was screened and 101 enrolled. Nasopharyngeal swabs were tested on days 3 or 4, 5, 7, 10, and 14, and the proportion of concordant negative results for each day versus day 14 with a two-sided 95% exact binomial confidence interval was determined. Rates of concordant negative test results were as follows: day 5 vs. day 14 = 45/50 (90%, 95% CI: 78–97%); day 7 vs. day 14 = 47/52 (90%, 95% CI: 79–97%); day 10 vs. day 14 = 48/53 (91%, 95% CI:79–97%), with no evidence of different negative rates between earlier days and day 14 by McNemar’s test, p > 0.05. Overall, 14 of 90 (16%, 95% CI: 9–25%) tested positive while in quarantine, with seven initial positive tests on day 3 or 4, 5 on day 5, 2 on day 7, and none on day 10 or 14. Based on concordance rates between day 7 and 14, we anticipate that 90% (range: 79–97%) of individuals who are negative on day 7 will remain negative on day 14, providing the first direct evidence that exposed asymptomatic students ages 18–44 years in a university setting are at low risk if released from quarantine at 7 days if they have a negative PCR test prior to release. In addition, the 16% positive rate supports the ongoing need to quarantine close contacts of COVID-19 cases.

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  1. Version published to 10.3390/covid2030020
  2. ScreenIT

    SciScore for 10.1101/2020.12.09.20246785: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: Individuals who elected to participate were called by study personnel and the consent process was performed over the telephone with an emailed consent document.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    STUDY DESIGN: START is a prospective cohort study.
    START
    suggested: (START, RRID:SCR_009394)

    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:
    The primary limitation is a potential lack of generalizability as it was conducted in a relatively young and asymptomatic population in a single geographic university setting and testing was performed by nasopharangeal swab. Whether these findings apply to a wider population or other testing methods are not known. In addition, we had a relatively large drop-out rate (11/101, 11%). Despite this, our estimates are precise and reliable and provide prospective confirmation of the current modeling estimates that suggest a 7day quarantine time is adequate in asymptomatic low-risk individuals. This study contributes important data to support a critically needed data-driven approach to COVID-19 related decision making.15 Finally, as noted in CDC guidelines, local public health departments guide local quarantine recommendations and decisions should be based on understanding and balancing the potential risk of shorter quarantine periods and consideration of local circumstances in this evolving pandemic.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04573634RecruitingA Registry Study of COVID-19 Serologic and Virologic Testing…

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.12.09.20246785v1 on medRxiv