Association of COVID-19 Quarantine Duration and Postquarantine Transmission Risk in 4 University Cohorts.

Autor: Liu AB; Bioinformatics and Integrative Genomics PhD Program, Harvard Medical School, Boston, Massachusetts., Davidi D; Department of Genetics, Harvard Medical School, Boston, Massachusetts., Landsberg HE; Student Health Services, Boston University, Boston, Massachusetts., Francesconi M; Harvard University Health Services, Boston, Massachusetts., Platt JT; Student Health Services, Boston University, Boston, Massachusetts., Nguyen GT; Harvard University Health Services, Boston, Massachusetts.; Department of Medicine, Harvard Medical School, Boston, Massachusetts., Yune S; Student Affairs Northeastern University, Boston, Massachusetts., Deckard A; Office of Information Technology, Duke University, Durham, North Carolina., Puglin J; Office of Assessment, Duke University, Durham, North Carolina., Haase SB; Department of Medicine, Duke University School of Medicine, Durham, North Carolina., Hamer DH; Department of Global Health, Boston University School of Public Health, Boston, Massachusetts.; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.; National Emerging Infectious Diseases Laboratory, Boston University, Boston, Massachusetts., Springer M; Department of Systems Biology, Harvard Medical School, Boston, Massachusetts.
Jazyk: angličtina
Zdroj: JAMA network open [JAMA Netw Open] 2022 Feb 01; Vol. 5 (2), pp. e220088. Date of Electronic Publication: 2022 Feb 01.
DOI: 10.1001/jamanetworkopen.2022.0088
Abstrakt: Importance: Optimal quarantine length for COVID-19 infection is unclear, in part owing to limited empirical data.
Objective: To assess postquarantine transmission risk for various quarantine lengths and potential associations between quarantine strictness and transmission risk.
Design, Setting, and Participants: Retrospective cohort study in 4 US universities from September 2020 to February 2021, including 3641 university students and staff who were identified as close contacts to individuals who tested positive for SARS-CoV-2 infection. Individuals were tested throughout the 10 to 14-day quarantine, and follow-up testing continued at least weekly throughout the 2020-2021 academic year.
Exposures: Strict quarantine, including designated housing with a private room, private bathroom, and meal delivery, vs nonstrict, which potentially included interactions with household members.
Main Outcomes and Measures: Dates of last known exposure, last negative test result, and first positive test result during quarantine.
Results: This study included 301 quarantined university students and staff who tested SARS-CoV-2-positive (of 3641 quarantined total). These 301 individuals had a median (IQR) age of 22.0 (20.0-25.0) years; 131 (43.5%) identified as female; and 20 (6.6%) were staff. Of the 287 self-reporting race and ethnicity according to university-defined classifications, 21 (7.3%) were African American or Black, 60 (20.9%) Asian, 17 (5.9%) Hispanic or Latinx, 174 (60.6%) White, and 15 (5.2%) other (including multiracial and/or multiethnic). Of the 301 participants, 40 (13.3%; 95% CI, 9.9%-17.6%) had negative test results and were asymptomatic on day 7 compared with 15 (4.9%; 95% CI, 3.0%-8.1%) and 4 (1.4%; 95% CI, 0.4%-3.5%) on days 10 and 14, respectively. Individuals in strict quarantine tested positive less frequently than those in nonstrict quarantine (10% vs 12%; P = .04).
Conclusions and Relevance: To maintain the 5% transmission risk used as the basis for US Centers for Disease Control and Prevention's 7-day test-based quarantine guidance, our data suggest that quarantine with quantitative polymerase chain reaction testing 1 day before intended release should be 10 days for nonstrict quarantine and 8 days for strict quarantine, as ongoing exposure during quarantine may be associated with the higher rate of positive test results following nonstrict quarantine.
Databáze: MEDLINE