At-home self-collection of saliva, oropharyngeal swabs and dried blood spots for SARS-CoV-2 diagnosis and serology: Post-collection acceptability of specimen collection process and patient confidence in specimens

Valentine-Graves, Mariah; Hall, Eric W.; Guest, Jodie L; Adam, Elizabeth; Valencia, Rachel; Shinn, Kaitlin; Hardee, Isabel; Sanchez, Travis; Siegler, Aaron J; Sullivan, Patrick S.

doi:10.1371/journal.pone.0236775

Cited by 80 publications

(84 citation statements)

References 24 publications

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“…Almost all students and staff in this study would take part in an asymptomatic SARS-Cov-2/COVID-19 testing programme again and would recommend it to others. PCR self-testing using throat swab or saliva was highly acceptable (as shown in other community samples) [ 15 ]. Testing adherence was high and 4 out of 5 students were confident in their test result.…”

Section: Discussionmentioning

confidence: 99%

Perceptions and Experiences of the University of Nottingham Pilot SARS-CoV-2 Asymptomatic Testing Service: A Mixed-Methods Study

Blake

Corner

Cirelli

et al. 2020

IJERPH

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We aimed to explore student and staff perceptions and experiences of a pilot SARS-CoV-2 asymptomatic testing service (P-ATS) in a UK university campus setting. This was a mixed-method study comprised of an online survey, and thematic analysis of qualitative data from interviews and focus groups conducted at the mid-point and end of the 12-week P-ATS programme. Ninety-nine students (84.8% female, 70% first year; 93.9% P-ATS participants) completed an online survey, 41 individuals attended interviews or focus groups, including 31 students (21 first year; 10 final year) and 10 staff. All types of testing and logistics were highly acceptable (virus: swab, saliva; antibody: finger prick) and 94.9% would participate again. Reported adherence to weekly virus testing was high (92.4% completed ≥6 tests; 70.8% submitted all 10 swabs; 89.2% completed ≥1 saliva sample) and 76.9% submitted ≥3 blood samples. Students tested to “keep campus safe”, “contribute to national efforts to control COVID-19”, and “protect others”. In total, 31.3% had high anxiety as measured by the Generalized Anxiety Disorder scale (GAD-7) (27.1% of first year). Students with lower levels of anxiety and greater satisfaction with university communications around P-ATS were more likely to adhere to virus and antibody tests. Increased adherence to testing was associated with higher perceived risk of COVID-19 to self and others. Qualitative findings revealed 5 themes and 13 sub-themes: “emotional responses to COVID-19”, “university life during COVID-19”, “influences on testing participation”, “testing physical and logistical factors” and “testing effects on mental wellbeing”. Asymptomatic COVID-19 testing (SARS-CoV-2 virus/antibodies) is highly acceptable to students and staff in a university campus setting. Clear communications and strategies to reduce anxiety are likely to be important for testing uptake and adherence. Strategies are needed to facilitate social connections and mitigate the mental health impacts of COVID-19 and self-isolation.

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Section: Discussionmentioning

confidence: 99%

Perceptions and Experiences of the University of Nottingham Pilot SARS-CoV-2 Asymptomatic Testing Service: A Mixed-Methods Study

Blake

Corner

Cirelli

et al. 2020

IJERPH

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“…However, viral load in the nasopharynx can wane in later disease stages, while the virus remains detectable in alternate specimens such as bronchioalveolar lavage or sputum, thus necessitating the validation of diagnostics tests in these specimens [ 3 , 4 , 5 ]. In addition, to overcome limitations in mass screening for early detection of SARS-CoV-2, saliva has been considered as alternate material to NPS [ 6 , 7 , 8 , 9 , 10 ]. NPS collection requires trained personnel while saliva collection is comparatively easy, needs little instruction and is amenable for self-collection.…”

Section: Introductionmentioning

confidence: 99%

High Efficacy of Saliva in Detecting SARS-CoV-2 by RT-PCR in Adults and Children

et al. 2021

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Rising demands for repetitive SARS-CoV-2 screens and mass testing necessitate additional test strategies. Saliva may serve as an alternative to nasopharyngeal swab (NPS) as its collection is simple, non-invasive and amenable for mass- and home testing, but its rigorous validation, particularly in children, is missing. We conducted a large-scale head-to-head comparison of SARS-CoV-2 detection by RT-PCR in saliva and NPS of 1270 adults and children reporting to outpatient test centers and an emergency unit. In total, 273 individuals were tested positive for SARS-CoV-2 in either NPS or saliva. SARS-CoV-2 RT-PCR results in the two specimens showed a high agreement (overall percent agreement = 97.8%). Despite lower viral loads in the saliva of both adults and children, detection of SARS-CoV-2 in saliva fared well compared to NPS (positive percent agreement = 92.5%). Importantly, in children, SARS-CoV-2 infections were more often detected in saliva than NPS (positive predictive value = 84.8%), underlining that NPS sampling in children can be challenging. The comprehensive parallel analysis reported here establishes saliva as a generally reliable specimen for the detection of SARS-CoV-2, with particular advantages for testing children, that is readily applicable to increase and facilitate repetitive and mass testing in adults and children.

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“…Small scale feasibility studies have evaluated DBS samples for SARS-CoV-2 antibody detection in high risk populations, using plate based enzyme immunoassays, with promising results [ [9] , [10] , [11] , [12] ]. Field studies indicate the DBS approach is likely to be acceptable [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Use of dried blood spot samples for SARS-CoV-2 antibody detection using the Roche Elecsys ® high throughput immunoassay

Mulchandani

Brown

Brooks

et al. 2021

Journal of Clinical Virology

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At-home self-collection of saliva, oropharyngeal swabs and dried blood spots for SARS-CoV-2 diagnosis and serology: Post-collection acceptability of specimen collection process and patient confidence in specimens

Cited by 80 publications

References 24 publications

Perceptions and Experiences of the University of Nottingham Pilot SARS-CoV-2 Asymptomatic Testing Service: A Mixed-Methods Study

Perceptions and Experiences of the University of Nottingham Pilot SARS-CoV-2 Asymptomatic Testing Service: A Mixed-Methods Study

High Efficacy of Saliva in Detecting SARS-CoV-2 by RT-PCR in Adults and Children

Use of dried blood spot samples for SARS-CoV-2 antibody detection using the Roche Elecsys ® high throughput immunoassay

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