From the Guidelines
The recommended duration of isolation for Coronavirus disease (COVID-19) is at least 10 days after symptom onset, along with fever resolution for 24 hours without antipyretics and improvement in other symptoms, before ending home isolation and returning to work, as patients are unlikely to be infectious after this point. This recommendation is based on the guidance provided by the National Psoriasis Foundation COVID-19 Task Force 1. The task force suggests that patients with psoriatic disease who become infected with SARS-CoV-2 should follow CDC guidance on home isolation and discuss with their healthcare providers when they can end home isolation.
Some key points to consider when determining the length of home isolation include:
- Waiting a minimum of 10 days after COVID-19 symptom onset
- Fever resolution for 24 hours without antipyretics
- Improvement in other symptoms
- A case-by-case approach for patients with severe cases of COVID-19 or those on medications with immunosuppressive effects
It's essential to note that the evidence from other studies, such as those published in 2020 and 2024 1, may provide additional guidance on COVID-19 diagnosis and treatment, but the most recent and relevant guidance for isolation duration comes from the National Psoriasis Foundation COVID-19 Task Force 1.
In terms of reducing the transmission of COVID-19, physical separation is crucial, as the virus spreads primarily through respiratory droplets when an infected person breathes, talks, coughs, or sneezes. Therefore, following the recommended isolation period and taking precautions, such as wearing a high-quality mask, can help prevent the spread of the virus to others.
From the Research
Recommended Duration of Isolation for COVID-19
The recommended duration of isolation for Coronavirus disease (COVID-19) varies based on several factors, including symptoms, test results, and individual characteristics.
- According to a study published in 2022 2, isolation could end after 5-9 days if symptoms were resolving or absent, fever was absent for ≥24 hours without fever-reducing medications, and an Abbott BinaxNOW COVID-19 Ag (BinaxNOW) rapid antigen test result was negative.
- Another study from 2021 3 estimated that the risk of releasing an individual who is still infectious is low (0-6.6%) if isolation ends after 10 days since symptom onset.
- A study published in 2021 4 recommended lifting isolation if the RT-PCR Ct-value of a naso- or oropharyngeal swab sample is over 30, indicating that the virus is no longer infectious.
- Data from a test-to-release from isolation strategy among fully vaccinated National Football League players and staff members with COVID-19 in 2021 5 showed that 46% received negative test results or had a subsequent RT-PCR test result with a Ct≥35 by day 6 postdiagnosis, and 84% before day 10.
- A study from 2023 6 found that ending isolation based on RT-PCR cycle threshold (Ct) value ≥38 for patients with COVID-19 requiring in-hospital therapy for longer than 20 days after symptom onset can improve bed utilization without the risk of transmission.
Factors Influencing Isolation Duration
Several factors can influence the duration of isolation, including:
- Symptom resolution or absence
- Fever absence for ≥24 hours without fever-reducing medications
- Negative antigen test results
- RT-PCR Ct-value
- Individual characteristics, such as previous infection or vaccination status
- Steroid use, which can be a risk factor for prolonged low Ct values 6
Precautions After Isolation
Even after ending isolation, individuals with COVID-19 should continue taking precautions, including correct and consistent mask use, for a full 10 days after symptom onset or initial positive test result if they are asymptomatic 5.