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-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, and the CDC COVID-19 and Response Team1
, 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
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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