A prospective diagnostic evaluation of accuracy of self-taken and healthcare worker-taken swabs for rapid COVID-19 testing

Savage, Helen R; Finch, Lorna; Body, Richard; Watkins, Rachel L.; Hayward, Gail; Cook, Eloïse; Atienzar, Ana I Cubas; Cuevas, Luís E.; MacPherson, Peter; Adams, Emily

doi:10.1371/journal.pone.0270715

Cited by 14 publications

(29 citation statements)

References 12 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only 15/45 (33%) of stage 2 participants reported being prescribed antibiotics for their sore throat and in those stage 2 participants with clinician-assessed FeverPAIN scores (using throat photographs taken by participants) (n=18), only 10% recommended immediate antibiotic prescriptions suggesting a low prevalence of bacterial infections. Sub-optimal swabbing technique may have impacted on the detection rate, but self-swabbing without training in lay individuals has been shown to be accurate for detecting COVID-19 ( 17 ) and some participants in this study had prior experience of self-swabbing for COVID-19. In addition, swabbing of other areas of the mouth has been shown to be accurate for streptococcus detection ( 18 ).…”

Section: Discussionmentioning

confidence: 93%

Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility study

Lown

Miles²,

Fisk³

et al. 2022

Front. Immunol.

Self Cite

View full text Add to dashboard Cite

IntroductionSore throat is a common reason for overuse of antibiotics. The value of inflammatory or biomarkers in throat swab or saliva samples in predicting benefit from antibiotics is unknown.MethodsWe used the ‘person-based approach’ to develop an online tool to support self-swabbing and recruited adults and children with sore throats through participating general practices and social media. Participants took bacterial and viral swabs and a saliva sponge swab and passive drool sample. Bacterial swabs were cultured for streptococcus (Group A, B, C, F and G). The viral swab and saliva samples were tested using a routine respiratory panel PCR and Covid-19 PCR testing. We used remaining viral swab and saliva sample volume for biomarker analysis using a panel of 13 biomarkers.ResultsWe recruited 11 asymptomatic participants and 45 symptomatic participants. From 45 symptomatic participants, bacterial throat swab, viral throat swab, saliva sponge and saliva drool samples were returned by 41/45 (91.1%), 43/45 (95.6%), 43/45 (95.6%) and 43/45 (95.6%) participants respectively. Three saliva sponge and 6 saliva drool samples were of insufficient quantity. Two adult participants had positive bacterial swabs. Six participants had a virus detected from at least one sample (swab or saliva). All of the biomarkers assessed were detectable from all samples where there was sufficient volume for testing. For most biomarkers we found higher concentrations in the saliva samples. Due to low numbers, we were not able to compare biomarker concentrations in those who did and did not have a bacterial pathogen detected. We found no evidence of a difference between biomarker concentrations between the symptomatic and asymptomatic participants but the distributions were wide.ConclusionsWe have demonstrated that it is feasible for patients with sore throat to self-swab and provide saliva samples for pathogen and biomarker analysis. Typical bacterial and viral pathogens were detected but at low prevalence rates. Further work is needed to determine if measuring biomarkers using oropharyngeal samples can help to differentiate between viral and bacterial pathogens in patients classified as medium or high risk using clinical scores, in order to better guide antibiotic prescribing and reduce inappropriate prescriptions.

show abstract

Section: Discussionmentioning

confidence: 93%

Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility study

Lown

Miles²,

Fisk³

et al. 2022

Front. Immunol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…As a result, in many of these studies, the sensitivity and specificity were found to be the same between healthcare providers and non-healthcare providers [ 11 , 17 , 18 , 21 , 23 , 37 ]. Indeed, Savage et al, 2022, revealed that the sensitivity of self-taken rapid antigen tests was higher (90.5%) compared with professional-taken tests (78.3%) [ 34 ]. Consequently, taking the samples from the examinees themselves does not seem to particularly affect the rapid antigen test results as long as they have been adequately informed about the correct sampling technique.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Accuracy of SARS-CoV-2 Nasal Rapid Antigen Self-Test: A Systematic Review and Meta-Analysis

Karlafti

Tsavdaris

Kotzakioulafi

et al. 2023

Life

View full text Add to dashboard Cite

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease 2019 (COVID-19), a disease that quickly spread into a pandemic. As such, management of the COVID-19 pandemic is deemed necessary, and it can be achieved by using reliable diagnostic tests for SARS-CoV-2. The gold standard for the diagnosis of SARS-CoV-2 is a molecular detection test using the reverse transcription polymerase chain reaction technique (rt-PCR), which is characterized by various disadvantages in contrast with the self-taken nasal rapid antigen tests that produce results faster, have lower costs and do not require specialized personnel. Therefore, the usefulness of self-taken rapid antigen tests is indisputable in disease management, facilitating both the health system and the examinees. Our systematic review aims to access the diagnostic accuracy of the self-taken nasal rapid antigen tests. Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to assess the risk of bias in the included studies. All the studies included in this systematic review were found after searching the two databases, Scopus and PubΜed. All but original articles were excluded from this systematic review, while all the studies concerning self-taken rapid antigen tests with a nasal sample and using rt-PCR as a reference test were included. Meta-analysis results and plots were obtained using RevMan software and the MetaDTA website. Results: All 22 studies included in this meta-analysis demonstrated a specificity of self-taken rapid antigen tests greater than 98%, which exceeds the minimum required yield for the diagnosis of SARS-CoV-2, according to the WHO. Notwithstanding, the sensitivity varies (from 40% to 98.7%), which makes them in some cases unsuitable for the diagnosis of positive cases. In the majority of the studies, the minimum required performance set by the WHO was achieved, which is 80% compared with rt-PCR tests. The pooled sensitivity of self-taken nasal rapid antigen tests was calculated as 91.1% and the pooled specificity was 99.5%. Conclusions: In conclusion, self-taken nasal rapid antigen tests have many advantages over rt-PCR tests, such as those related to the rapid reading of the results and their low cost. They also have considerable specificity and some self-taken rapid antigen test kits also have remarkable sensitivity. Consequently, self-taken rapid antigen tests have a wide range of utility but are not able to completely replace rt-PCR tests.

show abstract

“…The order of the swabs collected from an individual has been shown to influence the sensitivity of test performance ( 10 ). In Brazil, the Ag-RDT swab was taken first, followed by the reference swab, with the reverse being true for the United Kingdom.…”

Section: Discussionmentioning

confidence: 99%

Multicenter Diagnostic Evaluation of a Novel Coronavirus Antigen Lateral Flow Test among Symptomatic Individuals in Brazil and the United Kingdom

Faffe,

Byrne,

Body

et al. 2022

Microbiol Spectr

Self Cite

View full text Add to dashboard Cite

show abstract

A prospective diagnostic evaluation of accuracy of self-taken and healthcare worker-taken swabs for rapid COVID-19 testing

Cited by 14 publications

References 12 publications

Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility study

Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility study

The Diagnostic Accuracy of SARS-CoV-2 Nasal Rapid Antigen Self-Test: A Systematic Review and Meta-Analysis

Multicenter Diagnostic Evaluation of a Novel Coronavirus Antigen Lateral Flow Test among Symptomatic Individuals in Brazil and the United Kingdom

Contact Info

Product

Resources

About