Journal Article

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

Lee, Sing Ai, Chan, Yiong Huak, Tan, Cheryl Xiaotong, Tan, Pei Ting, Tey, Hong Liang, Toh, Song Tar, Tan, Seow Yen, Lim, Ernest Tian Hong, Siau, Chuin, Koh, Gerald Choon Huat, Tan, Thean Yen

2020

Overview

Self-sampling for SARS-CoV-2 would significantly raise testing capacity and reduce healthcare worker (HCW) exposure to infectious droplets personal, and protective equipment (PPE) use. We conducted a diagnostic accuracy study where subjects with a confirmed diagnosis of COVID-19 (n = 401) and healthy volunteers (n = 100) were asked to self-swab from their oropharynx and mid-turbinate (OPMT), and self-collect saliva. The results of these samples were compared to an OPMT performed by a HCW in the same patient at the same session. In subjects confirmed to have COVID-19, the sensitivities of the HCW-swab, self-swab, saliva, and combined self-swab plus saliva samples were 82.8%, 75.1%, 74.3% and 86.5% respectively. All samples obtained from healthy volunteers were tested negative. Compared to HCW-swab, the sensitivities of a self-swab sample and saliva sample were inferior by 8.7% (95%CI: 2.4% to 15.0%, p = 0.006) and 9.5% (95%CI: 3.1% to 15.8%, p = 0.003) respectively. The combined detection rate of self-swab and saliva had a sensitivity of 2.7% (95%CI: -2.6% to 8.0%, p = 0.321). The sensitivity of both the self-collection methods are higher when the Ct value of the HCW swab is less than 30. The specificity of both the self-swab and saliva testing was 100% (95% CI 96.4% to 100%). Our study provides evidence that sensitivities of self-collected OPMT swab and saliva samples were inferior to a HCW swab, but they could still be useful testing tools in the appropriate clinical settings.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Aged / Biology and Life Sciences / Bone / Coronaviruses / COVID-19 / COVID-19 - diagnosis / COVID-19 - virology / COVID-19 Testing / Diagnostic systems / Epistaxis / Female / Health care / Health Personnel / Hospitals / Humans / Informed consent / Male / Medical personnel / Medicine and Health Sciences / Middle Aged / Nasopharynx - virology / Nose / Occupational exposure / Oropharynx / Otolaryngology / Patients / People and Places / Personal protective equipment / Protective equipment / Research and Analysis Methods / Saliva / Saliva - virology / SARS-CoV-2 - genetics / SARS-CoV-2 - isolation & purification / Sensitivity / Sensitivity and Specificity / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Specimen Handling - methods / Supervision / Surgery / Turbinates - virology / Young Adult