Key Points Question What is the risk of SARS-CoV-2 transmission from individuals leaving test-based quarantines of various durations? Findings In this cohort study of 301 quarantined university students and staff who tested positive for COVID-19, 40 (13.3%) tested negative and were asymptomatic on day 7, implying an approximate 13% postquarantine transmission risk for 7-day test-based quarantine. Meaning To maintain the 5% transmission risk used as the basis for the 7-day guideline, our data suggest that quantitative polymerase chain reaction test–based, nonstrict quarantine should be 10 days. This cohort study evaluates transmission risk following quarantine periods of varying lengths and degrees of strictness among US university students and staff. 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.
【초록키워드】 COVID-19, quarantine, SARS-COV-2 infection, risk, Transmission, cohort study, SARS-CoV-2 transmission, Asymptomatic, COVID-19 infection, Control, age, Follow-up, Quantitative, African American, Guidance, association, Hispanic, Interaction, exposure, close contact, Asian, black, Participants, 95% CI, individual, measure, white, center, participant, positive test result, finding, positive, Latinx, negative test, objective, setting, first positive, polymerase chain, Result, tested, evaluate, median, less, maintain, Importance, Date, IQR, Point, Relevance, SARS-CoV-2–positive, 【제목키워드】 COVID-19, Duration, university,