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

• 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
• Journal Title: EMERGING INFECTIOUS DISEASES
• Volume: Volume 27, Number 8
• Publisher: CENTERS DISEASE CONTROL & PREVENTION | 2021-08-01, Pages 2081-2089
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.3201/eid2708.210667
• Subjects: Health Sciences, Immunology; Biology, Virology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Immunology; Infectious Diseases

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.