Diagnostic performance of different sampling approaches for SARS-CoV-2 RT-PCR testing: a systematic review and meta-analysis
Review (23 studies; n=7973 with 16 762 respiratory samples) found that compared with gold standard of nasopharyngeal swabs, pooled nasal & throat swabs offered best diagnostic performance of alternative sampling approaches for diagnosis of SARS-CoV-2 infection in ambulatory care
Source:
The Lancet Infectious Diseases
SPS commentary:
The pooled nasal and throat swabs gave the highest sensitivity of 97% (95% CI 93–100), whereas lower sensitivities were achieved by saliva (85%, 75–93) and nasal swabs (86%, 77–93) and a much lower sensitivity by throat swabs (68%, 35–94).
According to a commentary, considering the urgent need to increase testing capacity globally, this validation of self-collection methods could have an impact on testing strategies through reducing population movement, COVID-19 exposure risk, burden on human resources for sampling and testing, and need for using high-level personal protective equipment. It suggests that scaling up the self-collection of samples could lead to efficient control of SARS-CoV-2 in the community, while improving resource use and reducing occupational exposure risks for health-care workers. It adds that although self-sampling and rapid diagnostic tests could represent the tipping point in the fight against COVID-19, self-sampling and testing could become the norm beyond COVID-19, similar to at-home pregnancy tests, but before it can become the norm, there is a need to empower patients to understand and manage their self-diagnosis with appropriate resources.