Douglass Hanly Moir Pathology, 14 Giffnock Ave, Macquarie Park, NSW, 2113, Australia.
Sullivan Nicolaides Pathology, 24 Hurworth St, Bowen Hills, QLD, 4006, Australia.
J Clin Virol. 2020 Jul;128:104417. doi: 10.1016/j.jcv.2020.104417. Epub 2020 May 4.
To evaluate the reliability of self-collection for SARS-CoV-2 and other respiratory viruses because swab collections for SARS-CoV-2 put health workers at risk of infection and require use of personal protective equipment (PPE).
In a prospective study, patients from two states in Australia attending dedicated COVID-19 collection clinics were offered the option to first self-collect (SC) nasal and throat swabs (SCNT) prior to health worker collect (HC) using throat and nasal swabs (Site 1) or throat and nasopharyngeal swabs (Site 2). Samples were analysed for SARS-CoV-2 as well as common respiratory viruses. Concordance of results between methods was assessed using Cohen's kappa (κ) and Cycle threshold (Ct) values were recorded for all positive results as a surrogate measure for viral load.
Of 236 patients sampled by HC and SC, 25 had SARS-CoV-2 (24 by HC and 25 by SC) and 63 had other respiratory viruses (56 by HC and 58 by SC). SC was highly concordant with HC (κ = 0.890) for all viruses including SARS-CoV-2 and more concordant than HC to positive results by any method (κ = 0.959 vs 0.933). Mean SARS-CoV-2 E-gene and N-gene, rhinovirus and parainfluenza Ct values did not differ between HC and SCNT.
Self-collection of nasal and throat swabs offers a reliable alternative to health worker collection for the diagnosis of SARS-CoV-2 and other respiratory viruses and provides patients with easier access to testing, reduces exposure of the community and health workers to those being tested and reduces requirement for PPE.
评估自我采集用于 SARS-CoV-2 和其他呼吸道病毒检测的可靠性，因为采集 SARS-CoV-2 样本会使卫生工作者面临感染风险，并且需要使用个人防护装备（PPE）。
在一项前瞻性研究中，澳大利亚两个州的专门 COVID-19 采集诊所的患者被提供了两种选择：首先自行采集（SC）鼻和咽拭子（SCNT），然后由卫生工作者使用咽拭子和鼻拭子（第 1 站点）或咽拭子和鼻咽拭子（第 2 站点）进行采集（第 1 站点）或咽拭子和鼻咽拭子（第 2 站点）。对 SARS-CoV-2 以及常见呼吸道病毒进行了分析。使用 Cohen's kappa（κ）评估两种方法的结果一致性，并记录所有阳性结果的循环阈值（Ct）值作为病毒载量的替代测量值。
在由 HC 和 SC 采样的 236 名患者中，有 25 名患者的 SARS-CoV-2 检测结果为阳性（HC 检测阳性 24 例，SC 检测阳性 25 例），63 名患者的其他呼吸道病毒检测结果为阳性（HC 检测阳性 56 例，SC 检测阳性 58 例）。SC 与 HC 对所有病毒（包括 SARS-CoV-2）的一致性均很高（κ=0.890），并且比 HC 对任何方法的阳性结果的一致性都更高（κ=0.959 比 0.933）。HC 和 SCNT 的 SARS-CoV-2 E 基因和 N 基因、鼻病毒和副流感病毒的 Ct 值无差异。
自我采集鼻和咽拭子是卫生工作者采集的可靠替代方法，可用于 SARS-CoV-2 和其他呼吸道病毒的诊断，为患者提供更便捷的检测方式，减少社区和卫生工作者接触待检者的机会，并减少对 PPE 的需求。
