SARS-CoV-2 Screening Among Symptom-Free Healthcare Workers

Demmer, Ryan T.; Ulrich, Angela; Wiggen, Talia D; Strickland, Ali J; Naumchik, Brianna M; Kulasingam, Shalini; Stovitz, Steven D.; Marotz, Clarisse; Belda-Ferre, Pedro; Humphrey, Greg; Hoff, Peter De; Laurent, Louise C.; Kline, Susan; Knight, Rob

doi:10.1101/2020.07.31.20166066

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…After a short explanation, the same gesture could be performed by the patient itself. Self‐swabbing has been shown to improve voluntary participation for use in large population‐based respiratory carriage studies, with at least equal sensitivity and reduced costs (Coughtrie et al., 2014; Demmer et al, 2020). The act of self‐swabbing also potentially reduces the use of personal protective equipment, as the subject self‐performing swabbing does not need any material apart from proper hand disinfection before and after the act.…”

Section: Introductionmentioning

confidence: 99%

Nasopharyngeal swab‐induced pain for SARS‐CoV‐2 screening: A randomised controlled trial of conventional and self‐swabbing

Moisset

Gautier

Godet

et al. 2021

European Journal of Pain

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Background Massive screening campaigns for SARS‐CoV‐2 are currently carried out throughout the world, relying on reverse‐transcriptase‐polymerase chain reaction (RT‐PCR) following nasopharyngeal swabbing performed by a healthcare professional. Yet, due to the apprehension of pain induced by nasopharyngeal probing, poor adhesion to those screening campaigns can be observed. To enhance voluntary participation and to avoid unnecessary exposition to SARS‐CoV‐2, self‐swabbing could be proposed. To date, no data have been published concerning pain induced by conventional‐ or self‐swabbing. Thus, the primary objective of the present study was to evaluate pain induced with the conventional swabbing method and compare it to self‐swabbing. Secondary objectives focused on swabbing‐induced discomfort and acceptability of the two methods. Methods The study was conducted in Clermont‐Ferrand medical school (France). Overall, 190 students were randomised into two groups and experienced either self‐ or conventional‐swabbing. Each subject had to rate pain, discomfort and acceptability of such swabbing on a 0–10 numeric rating scale. Results No significant difference was found between the two methods. The mean pain level was 2.5 ± 1.9, 28% rating pain as ≥4/10. Discomfort was 4.8 ± 2.2, 66% indicating significant (≥4/10) discomfort. Higher pain and discomfort were associated with female sex. Acceptability was ≥8/10 for 89.0% of the subjects and all would have accepted to undergo a new test with the same technique if necessary. Conclusion Both conventional and self‐swabbing induce low levels of pain for most young healthy volunteers whereas discomfort is very frequent. Nonetheless, both methods are indifferently well‐accepted in medical students. Future studies amongst symptomatic subjects are awaited. Significance Using the thinnest available swabs, procedural pain induced by nasopharyngeal swabbing for SARS‐CoV‐2 screening is very low for most subjects and should not limit voluntary participation in screening campaigns. Self‐swabbing does not lead to more pain or discomfort compared to conventional swabbing, is well‐accepted, and could be proposed to optimize screening campaigns, at least in healthcare professionals.

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Section: Introductionmentioning

confidence: 99%

Nasopharyngeal swab‐induced pain for SARS‐CoV‐2 screening: A randomised controlled trial of conventional and self‐swabbing

Moisset

Gautier

Godet

et al. 2021

European Journal of Pain

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“…In addition to reducing the need for skilled HCWs and personal protective equipment (PPE), self-collection methods are scalable and allow for timely mass surveillance – which is all the more important with the emergence and spread of SARS-CoV-2 variants of concern. Unsupervised home self-collection has been performed by both HCWs and the public at large, ( McCulloch et al, 2020 ) with HCW volunteers largely agreeing to perform self-collected NP swabs for diagnosis or research purposes ( Demmer et al, 2020 ), and a majority of community dwellers agreeing to self-collecting a throat swab sample at home ( Hall et al, 2020 ). Self-collected swabs have a role in outbreak investigation and management ( Knoll et al, 2020 ), and in target populations that require serial testing ( O’Shea et al, 2020 ).…”

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confidence: 99%

Reliable detection of SARS-CoV-2 with patient-collected swabs and saline gargles: A three-headed comparison on multiple molecular platforms

LeBlanc

Pettipas

Quinzio

et al. 2021

Journal of Virological Methods

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With increasing demands for SARS-CoV-2 testing, as well as the shortages for testing supplies, collection devices, and trained healthcare workers (HCWs) to collect specimens, self-collection is an attractive prospect to reduce the need for HCWs and expenditure of personal protective equipment. Apart from the traditional nasopharyngeal swab used for SARS-CoV-2 detection, alternative specimens have been validated such as a combined swabs of the oropharynx and anterior nares (OP/N), or throat samples using saline gargles. Both the alternative specimen types are amenable to self-collection. Objectives. This study aimed to compare the sensitivity of HCW-collected (OP/N) swabs, self-collected OP/N swabs, and self-collected saline gargles. Among 38 individuals previously testing positive for SARS-CoV-2 (or their close contacts), two self-collected specimen types (OP/N and saline gargles) were compared to HCW-collected OP/N swabs. SARS-CoV-2 testing was performed on three molecular assays: a laboratory-developed test (LDT), and two commercial assays on automated platforms: Cobas 6800 (Roche Diagnostics) and Panther (Hologic). The sensitivity of self-collected OP/N swabs was equivalent to healthcare worker (HCW)-collected OP/N swabs at 100.0% [92.6% to 100.0%] for all three molecular tests. The sensitivity of saline gargles was not significantly different than HCW-collected OP/N swabs, but varied slightly between instruments at 93.8% [85.9% to 93.8%] for the LDT, 96.8% [88.6% to 96.8%] for the Cobas assay, and 96.7% [89.2% to 96.9%] for the Panther assay. Overall, self-collection using OP/N swabs or saline gargles are reasonable alternatives to HCW-based collections for SARS-CoV-2 detection, and could facilitate broader surveillance strategies.

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“…We employ the number of new deaths rather than the number of new infections because the latter number is very inaccurate due to two reasons. First, many people have little or no symptom after infection of SARS-CoV-2, 5 these people are not likely included in the number of infections. Second, number of infections heavily depends on the sufficiency of test facilities and reagents.…”

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confidence: 99%