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

Abstract

Background: Options to increase the ease of testing for SARS-CoV-2 infection and immune response are needed. Self-collection of diagnostic specimens at home offers an avenue to allow people to test for SARS-CoV-2 infection or immune response without traveling to a clinic or laboratory. Before this study, survey respondents indicated willingness to self-collect specimens for COVID-related tests, but hypothetical willingness can differ from post-collection acceptability after participants collect specimens. Methods: 153 US adults were enrolled in a study of the willingness and feasibility of patients to self-collect three diagnostic specimens (saliva, oropharyngeal swab (OPS) and dried blood spot (DBS) card) while observed by a clinician through a telehealth session. After the specimens were collected, 148 participants participated in a survey about the acceptability of the collection, packing and shipping process, and their confidence in the samples collected for COVID-related laboratory testing. Results: A large majority of participants (>84%) reported that collecting, packing and shipping of saliva, OPS, and DBS specimens were acceptable. Nearly nine in 10 (87%) reported being confident or very confident that the specimens they collected were sufficient for laboratory analysis. There were no differences in acceptability for any specimen type, packing and shipping, or confidence in samples by gender, age, race/ethnicity, or educational level. Conclusions: Self-collection of specimens for SARS-CoV-2 testing and preparing and shipping specimens for analysis were acceptable in a diverse group of US adults. Further refinement of materials and instructions to support self-collection of saliva, OPS and DBS specimens for COVID-related testing is needed.

Saliva as a possible tool for the SARS-CoV-2 detection: A review

“…A study evaluated the general acceptability of North American adults in relation to the collecting process, packaging and sending self-collected saliva samples, oropharyngeal swab and dried blood card [ 57 ]. It was possible to observe high acceptability and confidence in relation to the self-collection of both saliva and other samples by patients, which reinforces the possibility of facilitating mass screening processes, reducing the costs associated with collections.…”

Performance of At-Home Self-Collected Saliva and Nasal-Oropharyngeal Swabs in the Surveillance of COVID-19

“…Nevertheless, biological specimen collection is an important logistic challenge to provide massive testing (1)(2)(3). The possibility to use self-collected samples for COVID- 19 testing offers several advantages, especially to minimize the risk of exposing healthcare workers to the virus, since self-collection does not require direct involvement of trained personnel in the sample collection (4,5). Recently publications have been showed a similar sensitivity between saliva samples and nasal swabs collected by healthworkers and those collected by a patient for COVID-19 molecular diagnosis, thus providing an important background for the choice of this strategy for surveillance of COVID-19 (6)(7)(8).…”

Take-home kits to detect respiratory viruses among healthcare personnel: Lessons learned from a cluster randomized clinical trial

“…There is a strong preference to collect specimens at home over coming to a medical facility or even a drive-through setting 25 . When testing for SARS-CoV-2, the virus that causes COVID-19, regardless of the type of specimen, a recent survey shows that most participants (>84%) found the process acceptable and 87% were confident in their ability to successfully perform the sampling 26 . Some self-collected specimens, outside this study, would have been collected in a healthcare environment, potentially increasing risk of exposures and utilization of PPE.…”