Self-Collected versus Healthcare Worker-Collected Swabs in the Diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2

Johan H Therchilsen, Christian von Buchwald, Anders Koch, Susanne Dam Nielsen, Daniel B Rasmussen, Rebekka Faber Thudium, Nikolai S Kirkby, Daniel E T Raaschou-Pedersen, Johan S Bundgaard, Kasper Iversen, Henning Bundgaard, Tobias Todsen, Johan H Therchilsen, Christian von Buchwald, Anders Koch, Susanne Dam Nielsen, Daniel B Rasmussen, Rebekka Faber Thudium, Nikolai S Kirkby, Daniel E T Raaschou-Pedersen, Johan S Bundgaard, Kasper Iversen, Henning Bundgaard, Tobias Todsen

Abstract

The aim of this study was to compare the sensitivity of self-collected versus healthcare worker (HCW)-collected swabs for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) testing. Symptomatic individuals referred for SARS-CoV-2 testing were invited to provide mobile-phone video-instructed self-collected oropharyngeal and nasal samples followed by a HCW-collected oropharyngeal sample. All samples were sent for analysis to the same microbiology laboratory, and the number of SARS-CoV-2-positive participants in the two tests was compared. A total of 109 participants were included, and 19 participants had SARS-CoV-2-positive results. The diagnostic sensitivity of the self-collected and HCW-collected swabs was 84.2% and 89.5%, respectively, with an acceptable agreement, Cohens kappa 0.82, p < 0.001. Further, results from a questionnaire answered by the participants found that loss of smell as a self-reported symptom was a strong predictor for a SARS-CoV-2-positive test. In conclusion, we found that self-collected oropharyngeal and nasal swabs for SARS-CoV-2 testing can be reliable compared to HCW-collected oropharyngeal samples.

Keywords: COVID-19; COVID-19 diagnostic testing; severe acute respiratory syndrome coronavirus 2.

Conflict of interest statement

Swabs from Zymo Collection Swab, Zymo Research, Irvine, CA, USA were given free of charge by Nordic Biosite, 1301 Copenhagen, Denmark. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure A1
Figure A1
Written Instructions.
Figure A2
Figure A2
Questionnaire to the participants.
Figure 1
Figure 1
Study flowchart. SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, GP, general practitioner, HCW, healthcare worker.
Figure 2
Figure 2
Screenshots from the Supplementary Video S1 demonstrating how to perform self-collection of oropharyngeal and lower nasal samples with the use of a single swab for SARS-CoV-2 testing. Foto 1 shows the patient examining which nostril to use for collection the sample. Foto 2 shows collection of oropharyngeal sample. Foto 3 shows depth of insertion to collect middle turbinate sample. Foto 4 shows the patient performing middle turbinate sample. For more information please consult with Figure A1.

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Source: PubMed

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