Abstract

We screened 65 longitudinally-collected nasal swab samples from 31 children aged 0-16 years who were positive for SARS-CoV-2 omicron BA.1. By day 7 after onset of symptoms 48% of children remained positive by rapid antigen test. In a sample subset we found 100% correlation between antigen test results and virus culture.

Introduction

On July 20, 2020, CDC recommended that persons infected with SARS-CoV-2 isolate for a 10-day period, without requirements for an associated negative test for the virus [1]. This followed from studies showing that virtually all non-immunosuppressed patients with mild to moderate disease became culture-negative by day 10 of infection, with virus culture providing what was regarded as the optimal laboratory marker for infectivity [2-4]. The Florida Department of Health (FDOH) in an Emergency Rule issued August 6, 2021 [5] indicated that children infected with SARS-CoV-2 could return to school sooner than 10 days if they had a negative COVID test and were asymptomatic. On January 14, 2022, CDC changed their recommendation to say that children and adults infected with SARS-CoV-2 should isolate for 5 days, and, if afebrile, could then return to work/school but should wear a high-quality mask for an additional 5 days [6,7]. The FDOH position was changed on February 24, 2022, to say that children only needed to isolate for 5 days before returning to school, without further testing, and that masking was not necessary [8]. Given the variability in recommendations, we sought to characterize SARS-CoV-2 Omicron persistence and infectivity among children with mild illness in an outpatient setting.

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