{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:23:45Z","timestamp":1776731025477,"version":"3.51.2"},"reference-count":33,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Characterizing the clinical symptoms and evolution of community-based SARS-CoV-2 infections may inform health practitioners and public health officials in a rapidly changing landscape of population immunity and viral variants.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To compare COVID-19 symptoms among people testing positive with a rapid antigen test (RAT) during the Omicron BA.1 variant period (December 1, 2021, to January 30, 2022) with the pre-Delta (January 10 to May 31, 2021) and Delta (June 1 to November 30, 2021) variant periods and to assess the duration of RAT positivity during the Omicron BA.1 surge.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cross-sectional study was conducted from January 10, 2021, to January 31, 2022, at a walk-up community COVID-19 testing site in San Francisco, California. Participants included children and adults seeking COVID-19 testing with an RAT, regardless of age, vaccine status, or symptoms.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n Fisher exact tests or \u03c7\n 2<\/jats:sup>\n tests were used to compare COVID-19 symptoms during the Omicron BA.1 period with the pre-Delta and Delta periods for vaccination status and age group. Among people returning for repeated testing during the Omicron period, the proportion with a positive RAT between 4 and 14 days from symptom onset or since first positive test if asymptomatic was estimated.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 63\u202f277 persons tested (median [IQR] age, 32 [21-44] years, with 12.0% younger than 12 years; 52.0% women; and 68.5% Latinx), a total of 18\u202f301 people (28.9%) reported symptoms, of whom 4565 (24.9%) tested positive for COVID-19. During the Omicron BA.1 period, 3032 of 7283 symptomatic participants (41.6%) tested positive, and the numbers of these reporting cough and sore throat were higher than during pre-Delta and Delta periods (cough: 2044 [67.4%] vs 546 [51.3%] of 1065 participants,\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001 for pre-Delta, and 281 [60.0%] of 468 participants,\n P<\/jats:italic>\n \u2009=\u2009.002, for Delta; sore throat: 1316 [43.4%] vs 315 [29.6%] of 1065 participants,\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001 for pre-Delta, and 136 [29.1%] of 468 participants,\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001, for Delta). Compared with the 1065 patients with positive test results in the pre-Delta period, congestion among the 3032 with positive results during the Omicron BA.1 period was more common (1177 [38.8%] vs 294 [27.6%] participants,\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), and loss of taste or smell (160 [5.3%] vs 183 [17.2%] participants,\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and fever (921 [30.4%] vs 369 [34.7%] participants,\n P<\/jats:italic>\n \u2009=\u2009.01) were less common. In addition, during the Omicron BA.1 period, fever was less common among the people with positive test results who had received a vaccine booster compared with those with positive test results who were unvaccinated (97 [22.5%] of 432 vs 42 [36.2%] of 116 participants,\n P<\/jats:italic>\n \u2009=\u2009.003), and fever and myalgia were less common among participants who had received a booster compared with those with positive results who had received only a primary series (fever: 97 [22.5%] of 432 vs 559 [32.8%] of 1705 participants,\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001; myalgia: 115 [26.6%] of 432 vs 580 [34.0%] of 1705 participants,\n P<\/jats:italic>\n \u2009=\u2009.003). During the Omicron BA.1 period, 5 days after symptom onset, 507 of 1613 people (31.1%) with COVID-19 stated that their symptoms were similar, and 95 people (5.9%) reported worsening symptoms. Among people testing positive, 80.2% of participants who were symptomatic and retested remained positive 5 days after symptom onset.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cross-sectional study, COVID-19 upper respiratory tract symptoms were more commonly reported during the Omicron BA.1 period than during the pre-Delta and Delta periods, with differences by vaccination status. Rapid antigen test positivity remained high 5 days after symptom onset, supporting guidelines requiring a negative test to inform the length of the isolation period.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.35844","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T11:23:39Z","timestamp":1665401019000},"page":"e2235844","source":"Crossref","is-referenced-by-count":38,"title":["COVID-19 Symptoms and Duration of Rapid Antigen Test Positivity at a Community Testing and Surveillance Site During Pre-Delta, Delta, and Omicron BA.1 Periods"],"prefix":"10.1001","volume":"5","author":[{"given":"Carina","family":"Marquez","sequence":"first","affiliation":[{"name":"Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew D.","family":"Kerkhoff","sequence":"additional","affiliation":[{"name":"Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Schrom","sequence":"additional","affiliation":[{"name":"Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana","family":"Rojas","sequence":"additional","affiliation":[{"name":"The San Francisco Latino Task Force-Response to COVID-19, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas","family":"Black","sequence":"additional","affiliation":[{"name":"Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthea","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Chan-Zuckerberg Biohub, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Yu","family":"Wang","sequence":"additional","affiliation":[{"name":"Chan-Zuckerberg Biohub, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genay","family":"Pilarowski","sequence":"additional","affiliation":[{"name":"Unidos en Salud, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salustiano","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Bay Area Phlebotomy and Laboratory Services, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane","family":"Jones","sequence":"additional","affiliation":[{"name":"Unidos en Salud, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joselin","family":"Payan","sequence":"additional","affiliation":[{"name":"Unidos en Salud, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Manganelli","sequence":"additional","affiliation":[{"name":"Unidos en Salud, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susy","family":"Rojas","sequence":"additional","affiliation":[{"name":"Unidos en Salud, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Lemus","sequence":"additional","affiliation":[{"name":"Unidos en Salud, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Jain","sequence":"additional","affiliation":[{"name":"Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Chamie","sequence":"additional","affiliation":[{"name":"Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie","family":"Tulier-Laiwa","sequence":"additional","affiliation":[{"name":"The San Francisco Latino Task Force-Response to COVID-19, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Petersen","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, School of Public Health, University of California, Berkeley, Berkeley"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"DeRisi","sequence":"additional","affiliation":[{"name":"Chan-Zuckerberg Biohub, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane V.","family":"Havlir","sequence":"additional","affiliation":[{"name":"Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"key":"zoi221009r1","doi-asserted-by":"publisher","author":"Larremore","DOI":"10.1126\/sciadv.abd5393"},{"issue":"9","key":"zoi221009r2","doi-asserted-by":"publisher","first-page":"e3098","DOI":"10.1093\/cid\/ciaa1890","article-title":"Field performance and public health response using the BinaxNOW rapid severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen detection assay during community-based testing.","volume":"73","author":"Pilarowski","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"2","key":"zoi221009r3","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab023","article-title":"The COVID-19 symptom to isolation cascade in a Latinx community: a call to action.","volume":"8","author":"Rubio","year":"2021","journal-title":"Open Forum Infect Dis"},{"issue":"9","key":"zoi221009r4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003777","article-title":"Predictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people.","volume":"18","author":"Elliott","year":"2021","journal-title":"PLoS Med"},{"key":"zoi221009r5","doi-asserted-by":"publisher","author":"Vihta","DOI":"10.1093\/cid\/ciab945"},{"key":"zoi221009r6","doi-asserted-by":"publisher","article-title":"Omicron-associated changes in severe acute respiratory syndrome coronavirus (SARS-CoV-2) symptoms in the United Kingdom.","author":"Vihta","DOI":"10.1093\/cid\/ciac613"},{"key":"zoi221009r8","doi-asserted-by":"publisher","author":"Lefferts","year":"2022","DOI":"10.15585\/mmwr.mm7108a3"},{"key":"zoi221009r10","doi-asserted-by":"publisher","author":"Stiefel","DOI":"10.1017\/ice.2022.21"},{"issue":"7","key":"zoi221009r11","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1001\/jamainternmed.2022.1827","article-title":"Comparison of home antigen testing with RT-PCR and viral culture during the course of SARS-CoV-2 infection.","volume":"182","author":"Chu","year":"2022","journal-title":"JAMA Intern Med"},{"issue":"3","key":"zoi221009r12","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1056\/NEJMc2202092","article-title":"Duration of shedding of culturable virus in SARS-CoV-2 Omicron (BA.1) infection.","volume":"387","author":"Boucau","year":"2022","journal-title":"N Engl J Med"},{"issue":"1","key":"zoi221009r13","doi-asserted-by":"publisher","first-page":"22863","DOI":"10.1038\/s41598-021-02197-z","article-title":"Diagnostic performance of rapid antigen tests (RATs) for SARS-CoV-2 and their efficacy in monitoring the infectiousness of COVID-19 patients.","volume":"11","author":"Routsias","year":"2021","journal-title":"Sci Rep"},{"issue":"32","key":"zoi221009r14","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2020.25.32.2001483","article-title":"Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020.","volume":"25","author":"Singanayagam","year":"2020","journal-title":"Euro Surveill"},{"issue":"6551","key":"zoi221009r15","doi-asserted-by":"publisher","DOI":"10.1126\/science.abi5273","article-title":"Estimating infectiousness throughout SARS-CoV-2 infection course.","volume":"373","author":"Jones","year":"2021","journal-title":"Science"},{"key":"zoi221009r16","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1234","article-title":"Community transmission of severe respiratory syndrome coronavirus 2 disproportionately affects Latinx population during shelter-in-place in San Francisco.","author":"Chamie","journal-title":"Clin Infect Dis"},{"issue":"9","key":"zoi221009r17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0257111","article-title":"A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among Latinx populations: from theory to practice.","volume":"16","author":"Marquez","year":"2021","journal-title":"PLoS One"},{"key":"zoi221009r20","doi-asserted-by":"publisher","DOI":"10.7326\/M22-0202"},{"issue":"1","key":"zoi221009r21","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1093\/cid\/ciab283","article-title":"Estimation of secondary household attack rates for emergent spike L452R severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants detected by genomic surveillance at a community-based testing site in san francisco.","volume":"74","author":"Peng","year":"2022","journal-title":"Clin Infect Dis"},{"issue":"7902","key":"zoi221009r23","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1038\/s41586-022-04479-6","article-title":"SARS-CoV-2 Omicron variant replication in human bronchus and lung ex vivo.","volume":"603","author":"Hui","year":"2022","journal-title":"Nature"},{"issue":"21","key":"zoi221009r24","doi-asserted-by":"publisher","first-page":"785","DOI":"10.15585\/mmwr.mm7021e2","article-title":"COVID-19 testing to sustain in-person instruction and extracurricular activities in high schools\u2014Utah, November 2020-March 2021.","volume":"70","author":"Lanier","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"10","key":"zoi221009r26","doi-asserted-by":"publisher","first-page":"1592","DOI":"10.1093\/infdis\/jiaa474","article-title":"COVID-19 pandemic: disparate health impact on the Hispanic\/Latinx population in the United States.","volume":"222","author":"Macias Gil","year":"2020","journal-title":"J Infect Dis"},{"issue":"26","key":"zoi221009r29","doi-asserted-by":"publisher","first-page":"2489","DOI":"10.1056\/NEJMc2102507","article-title":"Viral dynamics of SARS-CoV-2 variants in vaccinated and unvaccinated persons.","volume":"385","author":"Kissler","year":"2021","journal-title":"N Engl J Med"},{"issue":"3","key":"zoi221009r30","doi-asserted-by":"publisher","first-page":"717","DOI":"10.3201\/eid2803.211747","article-title":"Relationship of SARS-CoV-2 antigen and reverse transcription PCR positivity for viral cultures.","volume":"28","author":"Currie","year":"2022","journal-title":"Emerg Infect Dis"},{"issue":"9","key":"zoi221009r31","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00896-21","article-title":"Evaluation of a rapid antigen test to detect SARS-CoV-2 infection and identify potentially infectious individuals.","volume":"59","author":"Korenkov","year":"2021","journal-title":"J Clin Microbiol"},{"key":"zoi221009r32","doi-asserted-by":"publisher","author":"Killingley","DOI":"10.1038\/s41591-022-01780-9"},{"issue":"7","key":"zoi221009r33","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.1038\/s41591-022-01816-0","article-title":"Infectious viral load in unvaccinated and vaccinated individuals infected with ancestral, Delta or Omicron SARS-CoV-2.","volume":"28","author":"Puhach","year":"2022","journal-title":"Nat Med"},{"key":"zoi221009r7","unstructured":"Centers for Disease Control and Prevention. Isolation and precautions for people with COVID-19: quarantine and isolation calculator. Published January 27, 2022. Accessed March 6, 2022. https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/your-health\/quarantine-isolation.html"},{"key":"zoi221009r9","doi-asserted-by":"crossref","unstructured":"Landon? E, Bartlett? AH, Marrs? R, Guenette? C, Weber? SG, Mina? MJ. High rates of rapid antigen test positivity after 5 days of isolation for COVID-19. medRxiv. 2022. Preprint posted online February 2, 2022. doi:10.1101\/2022.02.01.22269931?","DOI":"10.1101\/2022.02.01.22269931"},{"key":"zoi221009r18","unstructured":"Abbott Diagnostics. BinaxNOW COVID-19 Ag Card (PN195-000) instructions for use: package insert, version 1.6. Accessed October 20, 2020. https:\/\/www.fda.gov\/media\/141570\/download"},{"key":"zoi221009r19","unstructured":"Unidos en Salud. Reader decision tree for Abbott\u2019s BinaxNOW COVID-19 Ag Card test. Accessed December 17, 2020. https:\/\/unitedinhealth.org\/binax-training"},{"key":"zoi221009r22","unstructured":"California Department of Public Health. Guidance on isolation and quarantine for COVID-19 contact tracing. Accessed March 6, 2022. https:\/\/www.cdph.ca.gov\/Programs\/CID\/DCDC\/Pages\/COVID-19\/Guidance-on-Isolation-and-Quarantine-for-COVID-19-Contact-Tracing.aspx"},{"key":"zoi221009r25","doi-asserted-by":"crossref","unstructured":"Bilinski? A, Ciaranello? A, Fitzpatrick? MC, . SARS-CoV-2 testing strategies to contain school-associated transmission: model-based analysis of impact and cost of diagnostic testing, screening, and surveillance.? medRxiv. Preprint posted online August 10, 2021. doi:10.1101\/2021.05.12.21257131","DOI":"10.1101\/2021.05.12.21257131"},{"key":"zoi221009r27","unstructured":"US Bureau of Labor Statistics. 2019 National compensation survey-benefits. 2019. Accessed August 31, 2022. https:\/\/www.bls.gov\/ncs\/ebs\/"},{"key":"zoi221009r28","doi-asserted-by":"crossref","unstructured":"Hay? JA, Kissler? SM, Fauver? JR, . Viral dynamics and duration of PCR positivity of the SARS-CoV-2 Omicron variant.? medRxiv. Preprint posted online January 14, 2022. doi:10.1101\/2022.01.13.22269257","DOI":"10.1101\/2022.01.13.22269257"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2797070\/marquez_2022_oi_221009_1664382862.65415.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T11:23:43Z","timestamp":1665401023000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2797070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,10]]},"references-count":33,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.35844","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2022.05.19.22274968","asserted-by":"object"}]},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,10]]}}}