Effects of Patient Characteristics on Diagnostic Performance of Self-Collected Samples for SARS-CoV-2 Testing

• Type of Material: Article
• Authors: Sarah E. Smith-Jeffcoat, Centers for Disease Control and Prevention; Mitsuki Koh, Centers for Disease Control and Prevention; Adam Hoffman, Emory University; Paulina Rebolledo, Emory University; Marcos Schechter, Emory University; Halie K. Miller, Centers for Disease Control and Prevention; Sadia Sleweon, Centers for Disease Control and Prevention; Rebecca Rossetti, Centers for Disease Control and Prevention; Vyjayanti Kasinathan, Emory University; Hany Atallah, Emory University; Brooks Moore, Emory University; Yun Wang, Emory University; HL Kirking, Centers for Disease Control and Prevention
• Language: English
• Date: 2021-08-01
• Publisher: CENTERS DISEASE CONTROL & PREVENTION
• Publication Version: Final Published Version
• Copyright Statement: This is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
• Final Published Version (URL): http://dx.doi.org/10.3201/eid2708.210667
• Title of Journal or Parent Work: EMERGING INFECTIOUS DISEASES
• Volume: 27
• Issue: 8
• Start Page: 2081
• End Page: 2089
• Keywords: Life Sciences & Biomedicine; Infectious Diseases; Immunology; Science & Technology
• Research Categories: Health Sciences, Immunology; Biology, Virology

Abstract

We evaluated the performance of self-collected anterior nasal swab (ANS) and saliva samples compared with healthcare worker–collected nasopharyngeal swab specimens used to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We used the same PCR diagnostic panel to test all self-collected and healthcare worker–collected samples from participants at a public hospital in Atlanta, Georgia, USA. Among 1,076 participants, 51.9% were men, 57.1% were >50 years of age, 81.2% were Black (non-Hispanic), and 74.9% reported >1 chronic medical condition. In total, 8.0% tested positive for SARS-CoV-2. Compared with nasopharyngeal swab samples, ANS samples had a sensitivity of 59% and saliva samples a sensitivity of 68%. Among participants tested 3–7 days after symptom onset, ANS samples had a sensitivity of 80% and saliva samples a sensitivity of 85%. Sensitivity varied by specimen type and patient characteristics. These findings can help physicians interpret PCR results for SARS-CoV-2.