Skip directly to page options Skip directly to A-Z link
Volume 27, Number 8—August 2021
Research

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

Sarah E. Smith-JeffcoatComments to Author , 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, and the CDC COVID-19 and Response Team1
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.E. Smith-Jeffcoat, M. Koh, H.K. Miller, S. Sleweon, R. Rossetti, T. Shragai, K. O’Laughlin, C.C. Espinosa, G.M. Khalil, A.O. Adeyemo, A. Moorman, B.L. Bauman, K. Joseph, M. O’Hegarty, N. Kamal, C.D. Bohannon, B. Bankamp, C. Hartlodge, M.D. Bowen, A. Paulick, A.S. Gargis, C. Elkins, R.J. Stewart, J. da Silva, C. Biedron, J.E. Tate, H.L. Kirking); Public Health Institute—CDC Global Health Fellowship Program, Atlanta (M. Koh); Emory University, Atlanta (A. Hoffman, P.A. Rebolledo, M.C. Schechter, V. Kasinathan, H. Atallah, B.L. Moore, Y.F. Wang); Grady Memorial Hospital, Atlanta (A. Hoffman, P.A. Rebolledo, M.C. Schechter, V. Kasinathan, H. Atallah, B.L. Moore, Y.F. Wang)

Main Article

Figure 3

Ct values of self-collected and healthcare worker–collected samples for N1 target of severe acute respiratory syndrome coronavirus 2 PCR, Atlanta, Georgia, USA. PCR completed using CDC 2019-nCoV Real-Time Reverse Transcriptase PCR Diagnostic Panel (15). Horizontal lines within boxes indicate medians; box tops and bottoms indicate 25th and 75th percentiles; whiskers indicate the range. ANS, anterior nasal swab; Ct, cycle threshold; NPS, nasopharyngeal swab.

Figure 3. Ct values of self-collected and healthcare worker–collected samples for N1 target of severe acute respiratory syndrome coronavirus 2 PCR, Atlanta, Georgia, USA. PCR completed using CDC 2019-nCoV Real-Time Reverse Transcriptase PCR Diagnostic Panel (15). Horizontal lines within boxes indicate medians; box tops and bottoms indicate 25th and 75th percentiles; whiskers indicate the range. ANS, anterior nasal swab; Ct, cycle threshold; NPS, nasopharyngeal swab.

Download

Main Article

References
  1. World Health Organization. COVID-19 weekly epidemiological update—27 January 2021. 2021 Jan 27 [cited 2021 Feb 9]. https://www.who.int/publications/m/item/weekly-epidemiological-update---27-january-2021
  2. Centers for Disease Control and Prevention. Interim guidelines for collecting, handling, and testing clinical specimens for COVID-19. 2021 [cited 2021 Jan 29]. https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html
  3. Tu  Y-P, Jennings  R, Hart  B, Cangelosi  GA, Wood  RC, Wehber  K, et al. Swabs collected by patients or health care workers for SARS-CoV-2 testing. N Engl J Med. 2020;383:494–6. DOIPubMedGoogle Scholar
  4. McCormick-Baw  C, Morgan  K, Gaffney  D, Cazares  Y, Jaworski  K, Byrd  A, et al. Saliva as an alternate specimen source for detection of SARS-CoV-2 in symptomatic patients using Cepheid Xpert Xpress SARS-CoV-2. J Clin Microbiol. 2020;58:e01109–20. DOIPubMedGoogle Scholar
  5. Procop  GW, Shrestha  NK, Vogel  S, Van Sickle  K, Harrington  S, Rhoads  DD, et al. A direct comparison of enhanced saliva to nasopharyngeal swab for the detection of SARS-CoV-2 in symptomatic patients. J Clin Microbiol. 2020;58:e01946–20. DOIPubMedGoogle Scholar
  6. Hanson  KE, Barker  AP, Hillyard  DR, Gilmore  N, Barrett  JW, Orlandi  RR, et al. Self-collected anterior nasal and saliva specimens versus health care worker-collected nasopharyngeal swabs for the molecular detection of SARS-CoV-2. J Clin Microbiol. 2020;58:e01824–20. DOIPubMedGoogle Scholar
  7. Payne  DC, Smith-Jeffcoat  SE, Nowak  G, Chukwuma  U, Geibe  JR, Hawkins  RJ, et al.; CDC COVID-19 Surge Laboratory Group. SARS-CoV-2 infections and serologic responses from a sample of U.S. Navy service members—USS Theodore Roosevelt, April 2020. MMWR Morb Mortal Wkly Rep. 2020;69:714–21. DOIPubMedGoogle Scholar
  8. Yousaf  AR, Duca  LM, Chu  V, Reses  HE, Fajans  M, Rabold  EM, et al. A prospective cohort study in nonhospitalized household contacts with severe acute respiratory syndrome coronavirus 2 infection: symptom profiles and symptom change over time. Clin Infect Dis. 2020 Jul 28 [Epub ahead of print].
  9. Buitrago-Garcia  D, Egli-Gany  D, Counotte  MJ, Hossmann  S, Imeri  H, Ipekci  AM, et al. Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: A living systematic review and meta-analysis. PLoS Med. 2020;17:e1003346. DOIPubMedGoogle Scholar
  10. Sun  J, Xiao  J, Sun  R, Tang  X, Liang  C, Lin  H, et al. Prolonged persistence of SARS-CoV-2 RNA in body fluids. Emerg Infect Dis. 2020;26:1834–8. DOIPubMedGoogle Scholar
  11. COVID-19 Investigation Team. Clinical and virologic characteristics of the first 12 patients with coronavirus disease 2019 (COVID-19) in the United States. Nat Med. 2020;26:861–8. DOIPubMedGoogle Scholar
  12. Grady Health System. Grady fast facts. 2018 [cited 2021 Jan 29]. https://www.gradyhealth.org/wp-content/uploads/2018/07/Grady_Fast_Facts.pdf
  13. Centers for Disease Control and Prevention. How to collect your anterior nasal swab sample for COVID-19 testing. 2020 [cited 2021 Feb 12]. https://www.cdc.gov/coronavirus/2019-ncov/testing/How-To-Collect-Anterior-Nasal-Specimen-for-COVID-19.pdf
  14. Lu  X, Wang  L, Sakthivel  SK, Whitaker  B, Murray  J, Kamili  S, et al. US CDC real-time reverse transcription PCR panel for detection of severe acute respiratory syndrome coronavirus 2. Emerg Infect Dis. 2020;26:1654–65. DOIPubMedGoogle Scholar
  15. United States Food and Drug Administration. Emergency use authorization: CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel. 2020 [cited 2021 Mar 2]. https://www.fda.gov/media/134919/download
  16. Boehmer  TK, DeVies  J, Caruso  E, van Santen  KL, Tang  S, Black  CL, et al. Changing age distribution of the COVID-19 pandemic—United States, May–August 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1404–9. DOIPubMedGoogle Scholar
  17. Council of State and Territorial Epidemiologists. Update to the standardized surveillance case definition and national notification for 2019 novel coronavirus disease (COVID-19). 2020 [cited 2021 Jan 29]. https://cdn.ymaws.com/www.cste.org/resource/resmgr/ps/positionstatement2020/Interim-20-ID-02_COVID-19.pdf
  18. World Health Organization. RSV surveillance case definitions. 2020 [cited 2021 January 29]; https://www.who.int/influenza/rsv/rsv_case_definition/en
  19. Altamirano  J, Govindarajan  P, Blomkalns  AL, Kushner  LE, Stevens  BA, Pinsky  BA, et al. Assessment of sensitivity and specificity of patient-collected lower nasal specimens for severe acute respiratory syndrome coronavirus 2 testing [Erratum in: JAMA Netw Open. 2020;3: e2014910]. JAMA Netw Open. 2020;3:e2012005. DOIPubMedGoogle Scholar
  20. Kojima  N, Turner  F, Slepnev  V, Bacelar  A, Deming  L, Kodeboyina  S, et al. Self-collected oral fluid and nasal swabs demonstrate comparable sensitivity to clinician-collected nasopharyngeal swabs for the detection of SARS-CoV-2. Clin Infect Dis. 2020; Epub ahead of print. DOIGoogle Scholar
  21. Butler-Laporte  G, Lawandi  A, Schiller  I, Yao  M, Dendukuri  N, McDonald  EG, et al. Comparison of saliva and nasopharyngeal swab nucleic acid amplification testing for detection of SARS-CoV-2: a systematic review and meta-analysis. JAMA Intern Med. 2021;181:353–60. DOIPubMedGoogle Scholar
  22. Bastos  ML, Perlman-Arrow  S, Menzies  D, Campbell  JR. The sensitivity and costs of testing for SARS-CoV-2 infection with saliva versus nasopharyngeal swabs: a systematic review and meta-analysis. Ann Intern Med. 2021;174:501–10. DOIPubMedGoogle Scholar
  23. Migueres  M, Mengelle  C, Dimeglio  C, Didier  A, Alvarez  M, Delobel  P, et al. Saliva sampling for diagnosing SARS-CoV-2 infections in symptomatic patients and asymptomatic carriers. J Clin Virol. 2020;130:104580. DOIPubMedGoogle Scholar
  24. Tan  SY, Tey  HL, Lim  ETH, Toh  ST, Chan  YH, Tan  PT, et al. The accuracy of healthcare worker versus self collected (2-in-1) Oropharyngeal and Bilateral Mid-Turbinate (OPMT) swabs and saliva samples for SARS-CoV-2. PLoS One. 2020;15:e0244417. DOIPubMedGoogle Scholar
  25. Landry  ML, Criscuolo  J, Peaper  DR. Challenges in use of saliva for detection of SARS CoV-2 RNA in symptomatic outpatients. J Clin Virol. 2020;130:104567. DOIPubMedGoogle Scholar
  26. Van Vinh Chau  N, Lam  VT, Dung  NT, Yen  LM, Minh  NNQ, Hung  LM, et al.; Oxford University Clinical Research Unit COVID-19 Research Group. The natural history and transmission potential of asymptomatic severe acute respiratory syndrome coronavirus 2 infection. Clin Infect Dis. 2020;71:2679–87. DOIPubMedGoogle Scholar
  27. Williams  E, Bond  K, Zhang  B, Putland  M, Williamson  DA. Saliva as a noninvasive specimen for detection of SARS-CoV-2. J Clin Microbiol. 2020;58:e00776–20. DOIPubMedGoogle Scholar
  28. Salvatore  PP, Dawson  P, Wadhwa  A, Rabold  EM, Buono  S, Dietrich  EA, et al. Epidemiological correlates of polymerase chain reaction cycle threshold values in the detection of SARS-CoV-2. Clin Infect Dis. 2020;72:e761–7. DOIPubMedGoogle Scholar
  29. Wölfel  R, Corman  VM, Guggemos  W, Seilmaier  M, Zange  S, Müller  MA, et al. Virological assessment of hospitalized patients with COVID-2019. [Erratum in: Nature. 2020;588:E35]. Nature. 2020;581:465–9. DOIPubMedGoogle Scholar
  30. Food and Drug Administration. Individual EUAs for molecular diagnostic tests for SARS-CoV-2. 2021 [cited 2021 Feb 2]. https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-molecular

Main Article

1Members are listed at the end of this article.

Page created: June 10, 2021
Page updated: July 18, 2021
Page reviewed: July 18, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external