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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

Table 1

Characteristics of patients in study of diagnostic performance of self-collected samples for severe acute respiratory syndrome coronavirus 2 testing, Atlanta, Georgia, USA*

Characteristic
Total
PCR results for nasopharyngeal swab sample†
Positive
Negative
Total
1,076 (100.0)
80 (100.0)
926 (100.0)
Sex
F 514 (47.8) 36 (45.0) 445 (48.1)
M 559 (51.9) 44 (55.0) 479 (51.7)
Nonbinary 2 (0.2) 0 2 (0.2)
Refused/unknown
1 (0.1)
0
0
Age, y
18–29 145 (13.5) 8 (10.0) 122 (13.2)
30–39 155 (14.4) 12 (15.0) 128 (13.8)
40–49 162 (15.1) 18 (22.5) 139 (15.0)
50–59 308 (28.6) 20 (25.0) 271 (29.3)
>60
306 (28.4)
22 (27.5)
266 (28.7)
Race/ethnicity
American Indian/Alaska Native, non-Hispanic 2 (0.2) 0 2 (0.2)
Asian, non-Hispanic 10 (0.9) 1 (1.3) 9 (1.0)
Black, non-Hispanic 874 (81.2) 67 (83.8) 746 (80.6)
Hispanic/Latinx 71 (6.6) 8 (10.0) 60 (6.5)
Multiple race 16 (1.5) 0 15 (1.6)
Native Hawaiian/Pacific Islander, non-Hispanic 1 (0.1) 0 1 (0.1)
Unknown/other/refused 21 (2.0) 2 (2.5) 18 (1.9)
White, non-Hispanic
81 (7.5)
2 (2.5)
75 (8.1)
Chronic medical conditions
No condition reported 270 (25.1) 24 (30.0) 229 (24.7)
>1 condition reported 806 (74.9) 56 (70.0) 697 (75.3)
Emphysema or chronic obstructive pulmonary disorder 90 (8.4) 5 (6.3) 77 (8.3)
Asthma 224 (20.8) 13 (16.3) 192 (20.7)
Other chronic lung disease 65 (6.0) 6 (7.5) 55 (5.9)
Diabetes mellitus (type I or II) 259 (24.1) 22 (27.5) 219 (23.7)
Hypertension (high blood pressure) 491 (45.6) 32 (40.0) 425 (45.9)
Chronic heart or cardiovascular disease 154 (14.3) 8 (10.0) 135 (14.6)
Chronic kidney disease 76 (7.1) 2 (2.5) 68 (7.3)
Liver disease 40 (3.7) 3 (3.8) 34 (3.7)
Immunocompromising conditions‡ 91 (8.5) 6 (7.5) 78 (8.4)
Neurologic or neurodevelopmental disorders§ 110 (10.2) 4 (5.0) 94 (10.2)
Cancer (including in remission) 99 (9.2) 2 (2.5) 91 (9.8)
Other chronic diseases
178 (16.5)
12 (15.0)
155 (16.7)
Body mass index¶
Underweight 36 (3.4) 3 (3.8) 28 (3.0)
Normal weight 366 (34.0) 18 (22.5) 327 (35.3)
Overweight 271 (25.2) 18 (22.5) 236 (25.5)
Obese 394 (36.6) 40 (50.0) 328 (35.4)
Unknown
9 (0.8)
1 (1.2)
7 (0.8)
Enrollment location
Emergency department 861 (80.0) 74 (92.5) 722 (78.0)
Labor and delivery department 15 (1.4) 0 13 (1.4)
Preoperative screening clinic
200 (18.6)
6 (7.5)
191 (20.6)
Reason for visit
COVID-19 concern 196 (18.2) 31 (38.8) 153 (16.5)
No COVID-19 concern, but chief complaint included COVID-19–like symptoms 329 (30.6) 25 (31.2) 280 (30.2)
Admission to labor and delivery unit 10 (0.9) 0 8 (0.9)
Preoperative requirements 180 (16.7) 4 (5.0) 173 (18.7)
Other reasons
361 (33.6)
20 (25.0)
312 (33.7)
Known close contact with COVID-19 patient
Yes 129 (12.0) 16 (20.0) 107 (11.6)
Yes, <14 d since most recent exposure 30 (2.8) 9 (11.3) 19 (2.1)
No 890 (82.7) 56 (70.0) 775 (83.7)
Unknown
57 (5.3)
8 (10.0)
44 (4.8)
Reported a previous positive COVID-19 test
Yes 52 (4.8) 11 (13.8) 37 (4.0)
No
1,024 (95.2)
69 (86.2)
889 (96.0)
COVID-19 symptom status
Always asymptomatic 383 (35.6) 10 (12.5) 353 (38.1)
Currently asymptomatic 83 (7.7) 7 (8.8) 70 (7.6)
Currently symptomatic
610 (56.7)
63 (78.7)
503 (54.3)
Days since symptom onset#
0–2 187 (30.7) 19 (30.2) 150 (29.8)
3–7 233 (38.2) 26 (41.2) 194 (38.6)
8–14 84 (13.8) 12 (19.0) 67 (13.3)
>15 86 (14.1) 3 (4.8) 76 (15.1)
Unknown
20 (3.3)
3 (4.8)
16 (3.2)
Current signs and symptoms#
Fever, measured 52 (8.5) 14 (22.2) 32 (6.4)
Fever, subjective 122 (20.0) 26 (41.3) 88 (17.5)
Cough 324 (53.1) 42 (66.7) 266 (52.9)
Shortness of breath or difficulty breathing 346 (56.7) 33 (52.4) 289 (57.5)
Fatigue 306 (50.2) 43 (68.3) 243 (48.3)
Muscle or body aches 275 (45.1) 34 (54.0) 224 (44.5)
Headaches 212 (34.8) 28 (44.4) 168 (33.4)
New loss of taste 101 (16.6) 20 (31.7) 71 (14.1)
New loss of smell 72 (11.8) 18 (28.6) 48 (9.5)
Sore throat 135 (22.1) 14 (22.2) 112 (22.2)
Congestion or runny nose 230 (37.7) 23 (36.5) 188 (37.4)
Nausea 150 (24.6) 20 (31.7) 120 (23.9)
Vomiting 73 (12.0) 6 (9.5) 63 (12.5)
Diarrhea
121 (19.8)
11 (17.5)
103 (20.5)
Current symptom groups#
Respiratory symptoms 514 (84.3) 51 (81.0) 426 (84.7)
Upper respiratory symptoms 291 (47.7) 28 (44.4) 242 (48.1)
Lower respiratory symptoms 459 (75.2) 46 (73.0) 383 (76.1)
Nonrespiratory symptoms 504 (82.6) 58 (92.1) 411 (81.7)
Upper respiratory and loss of taste or smell 81 (13.3) 11 (17.5) 64 (12.7)
Gastrointestinal symptoms 214 (35.1) 23 (36.5) 178 (35.4)
Nonrespiratory symptoms excluding loss of taste or smell 493 (80.8) 55 (87.3) 404 (80.3)
Nonconstitutional symptoms
150 (24.6)
8 (12.7)
131 (26.0)
Case definitions#
COVID-19–like symptoms 106 (17.4) 23 (36.5) 77 (15.3)
COVID-19** 553 (90.7) 58 (92.1) 455 (90.5)
Influenza-like illness 34 (5.6) 10 (15.9) 19 (3.8)
Acute respiratory infection†† 513 (84.1) 50 (79.4) 426 (84.7)

*Values are no. (%). Percentages rounded to form a sum of 100.0%. COVID-19, coronavirus disease. †Using CDC 2019-nCoV Real-Time Reverse Transcriptase PCR Diagnostic Panel (15). ‡For example, HIV co-infection (not virally suppressed) or history of chemotherapy within past 12 mo, solid organ or bone marrow transplant, long-term steroid use (i.e., 20 mg for >1 mo), immunosuppressant use, or use of tumor necrosis factor alpha inhibitors. §e.g., seizure disorders, Alzheimer’s disease, dementia, traumatic brain injuries, or stroke. ¶Calculated using self-reported height and weight. #Among currently symptomatic participants. **According to definition established by the Council of State and Territorial Epidemiologists (17). ††According to definition established by the World Health Organization (18).

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1Members are listed at the end of this article.

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Page updated: July 18, 2021
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