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The accuracy of healthcare worker versus self collected (2-in-1) Oropharyngeal and Bilateral Mid-Turbinate (OPMT) swabs and saliva samples for SARS-CoV-2.
Tan, Seow Yen; Tey, Hong Liang; Lim, Ernest Tian Hong; Toh, Song Tar; Chan, Yiong Huak; Tan, Pei Ting; Lee, Sing Ai; Tan, Cheryl Xiaotong; Koh, Gerald Choon Huat; Tan, Thean Yen; Siau, Chuin.
  • Tan SY; Department of Infectious Diseases, Changi General Hospital, Singapore, Singapore.
  • Tey HL; Department of Dermatology, National Skin Centre, Singapore, Singapore.
  • Lim ETH; Emergency Department, Woodlands Health Campus, Singapore, Singapore.
  • Toh ST; Department of Otorhinolaryngology- Head and Neck Surgery, Singapore General Hospital, Singapore, Singapore.
  • Chan YH; Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore, Singapore.
  • Tan PT; Clinical Trials and Research Unit, Changi General Hospital, Singapore, Singapore.
  • Lee SA; Sheares Healthcare Group Pte Ltd, Singapore, Singapore.
  • Tan CX; Temasek International Pte Ltd, Singapore, Singapore.
  • Koh GCH; MOH Office for Healthcare Transformation, Singapore, Singapore.
  • Tan TY; Department of Laboratory Medicine, Changi General Hospital, Singapore, Singapore.
  • Siau C; Department of Respiratory & Critical Care Medicine, Changi General Hospital, Singapore, Singapore.
PLoS One ; 15(12): e0244417, 2020.
Article in English | MEDLINE | ID: covidwho-978948
Preprint
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ABSTRACT

BACKGROUND:

Self-sampling for SARS-CoV-2 would significantly raise testing capacity and reduce healthcare worker (HCW) exposure to infectious droplets personal, and protective equipment (PPE) use.

METHODS:

We conducted a diagnostic accuracy study where subjects with a confirmed diagnosis of COVID-19 (n = 401) and healthy volunteers (n = 100) were asked to self-swab from their oropharynx and mid-turbinate (OPMT), and self-collect saliva. The results of these samples were compared to an OPMT performed by a HCW in the same patient at the same session.

RESULTS:

In subjects confirmed to have COVID-19, the sensitivities of the HCW-swab, self-swab, saliva, and combined self-swab plus saliva samples were 82.8%, 75.1%, 74.3% and 86.5% respectively. All samples obtained from healthy volunteers were tested negative. Compared to HCW-swab, the sensitivities of a self-swab sample and saliva sample were inferior by 8.7% (95%CI 2.4% to 15.0%, p = 0.006) and 9.5% (95%CI 3.1% to 15.8%, p = 0.003) respectively. The combined detection rate of self-swab and saliva had a sensitivity of 2.7% (95%CI -2.6% to 8.0%, p = 0.321). The sensitivity of both the self-collection methods are higher when the Ct value of the HCW swab is less than 30. The specificity of both the self-swab and saliva testing was 100% (95% CI 96.4% to 100%).

CONCLUSION:

Our study provides evidence that sensitivities of self-collected OPMT swab and saliva samples were inferior to a HCW swab, but they could still be useful testing tools in the appropriate clinical settings.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Saliva / Specimen Handling / Turbinates / Nasopharynx / SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0244417

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Saliva / Specimen Handling / Turbinates / Nasopharynx / SARS-CoV-2 / COVID-19 Type of study: Diagnostic study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0244417