Antigen Diagnostic Tests With Self-Collection Of Biological Material For The Diagnosis Of COVID-19

ABSTRACT

Introduction. The self-test for COVID-19 has been a widely used strategy in some countries, especially in the context of back to face-toface work and educational activities. However, it is necessary to discuss the accuracy of antigen tests for the diagnosis of COVID-19. Methods. A systematic review was carried out. The strategy was defined by the researchers using the terms Covid-19 and Selftesting and their respective synonyms, including studies with data collection from 01/01/2021. Searches were carried out on October 20, 2021, in several databases. Results. A total of 504 studies were identified, four of which were included in this review two self-tests of nasopharyngeal collection antigen compared to reverse transcriptase polymerase chain reaction (RT-PCR);a supervised and self-collected anterior nasal smear selftest;and a study that evaluated the performance of six self-collected rapid antigen tests against quantitative RT-PCR (gargle, sputum, and spit). Saliva self-tests were found to have low sensitivity (<45%), while anterior nasal or nasopharyngeal swab self-tests had greater than 80 percent sensitivity. In all self-tests, the specificity was less than 85 percent. The diagnostic accuracy of self-tests for the different SARS-CoV-2 variants was not identified. Conclusions. The use of self-tests as a screening strategy is recommended, being a strategy with a significant impact on the surveillance and control of SARS-CoV-2 transmission. Further studies are needed to assess (i) accuracy considering the concern variants, (ii) safety of tests with self-collection of biological material, and (iii) disposal of biological waste.