Emerging Infectious Diseases (Aug 2021)

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

  • Sarah E. Smith-Jeffcoat,
  • Mitsuki Koh,
  • Adam Hoffman,
  • Paulina A. Rebolledo,
  • Marcos C. Schechter,
  • Halie K. Miller,
  • Sadia Sleweon,
  • Rebecca Rossetti,
  • Vyjayanti Kasinathan,
  • Talya Shragai,
  • Kevin O’Laughlin,
  • Catherine C. Espinosa,
  • George M. Khalil,
  • AdeSubomi O. Adeyemo,
  • Anne Moorman,
  • Brenda L. Bauman,
  • Kahaliah Joseph,
  • Michelle O’Hegarty,
  • Nazia Kamal,
  • Hany Atallah,
  • Brooks L. Moore,
  • Caitlin D. Bohannon,
  • Bettina Bankamp,
  • Claire Hartloge,
  • Michael D. Bowen,
  • Ashley Paulick,
  • Amy S. Gargis,
  • Christopher Elkins,
  • Rebekah J. Stewart,
  • Juliana da Silva,
  • Caitlin Biedron,
  • Jacqueline E. Tate,
  • Yun F. Wang,
  • Hannah L. Kirking

DOI
https://doi.org/10.3201/eid2708.210667
Journal volume & issue
Vol. 27, no. 8
pp. 2081 – 2089

Abstract

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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.

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