Test Us At Home Daily

Background: The purpose of this study was to evaluate how rapid antigen tests performed during the earliest stages of SARS-CoV-2 infection among people who were symptomatic or recently exposed. Understanding early diagnostic performance was important because delays in detection increased the risk of transmission in homes, workplaces, and community settings.

Materials/Methods: The study enrolled participants who reported symptoms consistent with COVID-19 or confirmed close contact with someone who tested positive. Each participant completed daily testing for 10 days. At each testing point, participants first performed a home rapid antigen test using either a Quidel or Abbott test. After completing the antigen test, participants collected a second nasal swab at home and shipped the sample to a CLIA-certified laboratory. The laboratory evaluated each sample using a highly sensitive RT-qPCR assay (Roche, limit of detection 1,800 NDU/mL). Viral sequencing was conducted on PCR-positive samples to support genomic surveillance.

Outcome/Impact: The study produced detailed temporal data showing how early in the infection course rapid antigen tests detected SARS-CoV-2 compared with RT-qPCR. The findings helped clarify the relationship between symptom onset, viral load, and antigen test positivity. The sequencing results supported variant tracking during the study period and contributed to broader national surveillance. Sequencing data from this study are available in the Sequence Read Archive (SRA) repository and can be accessed here: https://www.ncbi.nlm.nih.gov/bioproject/988481.