AB035. Comparative sensitivity of different self-sampling methods for SARS-CoV-2 RT-PCR testing
Abstract

AB035. Comparative sensitivity of different self-sampling methods for SARS-CoV-2 RT-PCR testing

Nicole Ngai Yung Tsang, Hau Chi So, Ka Yan Ng, Benjamin J. Cowling, Gabriel M. Leung, Dennis Kai Ming Ip

WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China

Correspondence to: Dennis Kai Ming Ip. WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. Email: dkmip@hku.hk.

Background: Alternative sampling methods allow for the possibility for self-collection to facilitate SARS-CoV-2 testing in ambulatory care settings. Self-sampling has been well defined for influenza in community settings, but remains unclear in the context of coronavirus disease (COVID-19). A systematic review and meta-analysis assessing the comparative sensitivity of different self-sampling methods for SARS-CoV-2 testing is needed.

Methods: In this meta-analysis, we systematically searched 4 different databases and 2 preprint platforms. We included original clinical studies that examined the performance of nasopharyngeal swabs and any additional respiratory specimens for the diagnosis of SARS-CoV-2 infection among individuals presenting in ambulatory care. Studies without data on paired samples, or those that only examined different samples from confirmed SARS-CoV-2 cases were not useful for examining diagnostic performance of a test and were excluded. Sensitivity of the diagnostic test was examined using random effects models.

Results: A total of 26 studies including 9684 participants were included. Using nasopharyngeal swabs as the gold standard, pooled nasal and throat swabs gave the highest sensitivity of 97% [95% confidence interval (CI): 93–100%], whereas lower sensitivities were achieved by nasal swabs (86%, 77–93%), saliva (85%, 75–93%) and gargle (85%, 65–98%), and a much lower sensitivity by throat swabs (68%, 35–94%). Comparison between health-care-worker collection and self-collection for pooled nasal and throat swabs and nasal swabs showed comparable sensitivity.

Conclusions: Our review suggests that pooled nasal and throat swabs would be the best alternative sampling approach to nasopharyngeal swabs, for diagnosis of SARS-CoV-2 infection in ambulatory care. Saliva, gargle and nasal swabs gave a comparably good and still reasonable sensitivity and are clinically acceptable alternative sampling approaches. All these alternative sampling approaches appeared as a feasible option to facilitate self-collection of specimens and scaling up of diagnostic testing programs. Throat swabs gave a much lower sensitivity and should not be recommended.

Keywords: SARS-CoV-2; coronavirus disease (COVID-19); diagnosis; sampling approach; nasal and throat swab

Acknowledgments

Funding: This project was supported by the Theme-based Research Scheme (T11-712/19-N) of the Research Grants Council of the Hong Kong Special Administrative Region Government.

Footnote

Conflicts of Interest: BJC has consulted for Roche, Sanofi Pasteur, GSK, AstraZeneca and Moderna. The other authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/jphe-21-ab035
Cite this abstract as: Tsang NNY, So HC, Ng KY, Cowling BJ, Leung GM, Ip DKM. AB035. Comparative sensitivity of different self-sampling methods for SARS-CoV-2 RT-PCR testing. J Public Health Emerg 2021;5:AB035.

Article Options

Download Citation

Share