From the Guidelines
For the newer COVID variants, it's generally recommended to isolate for at least 10 days after COVID-19 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 guidance is based on the most recent and highest quality study available, which suggests that patients with mild to moderate disease can typically self-isolate for 10 days following a positive SARS-CoV-2 PCR test 1. However, some individuals, especially those with severe cases of COVID-19 or when patients with psoriasis are on medications with immunosuppressive effects, may need to isolate for up to 15-20 days 1. It's also important to note that PCR positivity does not correlate with secretion of live virus, so it's of little or no value in assessing the risk of infectivity in the 3 months after confirmed SARS-CoV-2 infection 1.
Some key points to consider when determining the length of home isolation include:
- Fever resolution for 24 hours without antipyretics
- Improvement in other symptoms
- Severity of illness
- Immunosuppressive effects of medications
- Risk of transmission to high-risk individuals
It's also important to follow CDC guidance on home isolation and discuss with healthcare providers when to end home isolation, as they can provide personalized guidance based on individual circumstances 1. Additionally, patients with close contact to someone with SARS-CoV-2 infection should quarantine themselves for 14 days after the last contact and discuss the management of their psoriatic disease treatment with their medical provider(s) 1.
In terms of reducing transmission, it's essential to wear a high-quality mask around others for an additional 5 days after ending isolation and avoid contact with high-risk individuals when possible for the full 10 days. Testing is not required to end isolation, but a negative rapid antigen test can help determine if you're still likely to be contagious. This guidance reflects the understanding that most COVID transmission occurs early in the illness, typically in the 1-2 days before symptoms begin and the 2-3 days after. The newer variants generally follow similar transmission patterns to previous variants, though they may be more contagious.
From the Research
Isolation Duration for Newer COVID Variant
The duration of isolation for individuals infected with the newer COVID variant is not explicitly stated in the provided studies. However, the studies discuss the efficacy of various antiviral treatments, including Molnupiravir and Nirmatrelvir/Ritonavir, in reducing hospitalization and mortality rates.
Key Findings
- A study published in 2023 found that treatment with Molnupiravir or Nirmatrelvir/Ritonavir significantly reduced the time to negative swab test result compared to standard of care 2.
- Another study published in 2023 reported that Nirmatrelvir/Ritonavir demonstrated a greater risk reduction in hospitalization and death than Molnupiravir compared to placebo, and that both drugs need to be started within 5 days of symptoms onset and given for 5 days' duration 3.
- A systematic review published in 2024 found that the pooled estimate in reducing deaths and hospitalization for Molnupiravir was 0.62, and the pooled estimate for Nirmatrelvir/Ritonavir was 0.33, although the overall pooled effects were nonsignificant 4.
- A prospective study published in 2023 found that treatment with Ritonavir-Nirmatrelvir or Molnupiravir was associated with low rates of severe COVID-19 in patients with multiple myeloma 5.
- An animal study published in 2022 found that combination therapy with Nirmatrelvir and Molnupiravir improved the survival of SARS-CoV-2 infected mice 6.
Considerations for Isolation Duration
- The studies suggest that antiviral treatment can reduce the duration of viral shedding and improve clinical outcomes.
- However, the optimal duration of isolation for individuals infected with the newer COVID variant is not clearly defined in the provided studies.
- Further research is needed to determine the most effective strategies for reducing transmission and improving outcomes in individuals infected with the newer COVID variant.