Abstract
The simplicity and low cost of rapid point-of-care tests greatly facilitate large-scale population testing, which can contribute to controlling the spread of the COVID-19 virus. We evaluated the applicability of a self-testing strategy for SARS-CoV2 in a population-based, cross-sectional study in Cantabria, Spain, between April and May 2020. For the self-testing strategy, participants received the necessary material for the self-collection of blood and performance of a rapid antibody test using lateral flow immunoassay at home without the supervision of healthcare personnel. A total of 1,022 participants were enrolled. Most participants correctly performed the COVID-19 self-test the first time (91.3% [95% CI 89.4–92.9]). Only a minority of the participants (0.7%) needed the help of healthcare personnel, while 6.9% required a second kit delivery, for a total valid test result in 96.9% of the participants. Incorrect use of the self-test was not associated with the educational level, age over 65, or housing area. Prevalence of IgG antibodies against SARS-CoV2 for subjects with a valid rapid test result was 3.1% (95% CI 2.2–4.4), similar to the seroprevalence result obtained using a conventional approach carried out by healthcare professionals. In conclusion, COVID-19 self-testing should be considered as a screening tool.
Highlights
The high transmissibility of SARS-CoV2, even in asymptomatic patients, indicates that diagnosis based on symptoms and contact tracing alone is insufficient to contain the COVID-19 pandemic
We considered an incorrect use of the self-test when sending a second kit was necessary, the control band did not appear in the rapid test picture sent, and specialized healthcare personnel assisted in its performance
Around one half of participants reported symptoms suggestive of COVID-19 in the past three months, but only 79 (7.7%) participants were previously subjected to molecular testing to detect SARS-CoV2 infection, of whom four (5%) had a positive result
Summary
The high transmissibility of SARS-CoV2, even in asymptomatic patients, indicates that diagnosis based on symptoms and contact tracing alone is insufficient to contain the COVID-19 pandemic. Detection of viral genome by reverse transcription polymerase chain reaction (RT-PCR) performed with respiratory specimens, especially with nasopharyngeal swabs, are the cornerstone of SARS-CoV2 infection diagnostic testing[3]. These techniques require specialized healthcare personnel, centralized laboratory facilities, and time to provide results; the widespread use of these techniques has economic and logistical limitations. Recent studies showed that saliva is useful in diagnosing COVID-1910 This has the advantage of being self-collected by the subject. The simplicity and low cost of these rapid tests greatly
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