{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T03:51:09Z","timestamp":1782877869355,"version":"3.54.5"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T00:00:00Z","timestamp":1611792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Quest Diagnostics Incorporated"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The use of a remote specimen collection strategy employing a kit designed for unobserved self-collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction (RT-PCR) can decrease the use of personal protective equipment (PPE) and exposure risk. To assess the impact of unobserved specimen self-collection on test performance, we examined results from a SARS-CoV-2 qualitative RT-PCR test for self-collected specimens from participants in a return-to-work screening program and assessed the impact of a pooled testing strategy in this cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Self-collected anterior nasal swabs from employee return-to-work programs were tested using the Quest Diagnostics Emergency Use Authorization SARS-CoV-2 RT-PCR. The cycle threshold (Ct) values for the N1 and N3 N-gene targets and a human RNase P (RP) gene control target were tabulated. For comparison, we utilized Ct values from a cohort of health care provider\u2013collected specimens from patients with and without coronavirus disease 2019 symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 47\u2005923 participants, 1.8% were positive. RP failed to amplify for 13\/115\u2005435 (0.011%) specimens. The median (interquartile range) Cts were 32.7 (25.0\u201335.7) for N1 and 31.3 (23.8\u201334.2) for N3. Median Ct values in the self-collected cohort were significantly higher than those of symptomatic but not asymptomatic patients. Based on Ct values, pooled testing with 4 specimens would have yielded inconclusive results in 67\/1268 (5.2%) specimens but only a single false-negative result.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Unobserved self-collection of nasal swabs provides adequate sampling for SARS-CoV-2 RT-PCR testing. These findings alleviate concerns of increased false negatives in this context. Specimen pooling could be used for this population, as the likelihood of false-negative results is very low when using a sensitive, dual-target methodology.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofab039","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T07:26:27Z","timestamp":1611818787000},"source":"Crossref","is-referenced-by-count":11,"title":["Performance of Unobserved Self-Collected Nasal Swabs for Detection of SARS-CoV-2 by RT-PCR Utilizing a Remote Specimen Collection Strategy"],"prefix":"10.1093","volume":"8","author":[{"given":"Ron M","family":"Kagan","sequence":"first","affiliation":[{"name":"Quest Diagnostics Infectious Disease, San Juan Capistrano, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy A","family":"Rogers","sequence":"additional","affiliation":[{"name":"Quest Diagnostics Infectious Disease, San Juan Capistrano, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwynngelle A","family":"Borillo","sequence":"additional","affiliation":[{"name":"Quest Diagnostics Infectious Disease, San Juan Capistrano, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel J","family":"Clarke","sequence":"additional","affiliation":[{"name":"Quest Diagnostics Nichols Institute, San Juan Capistrano, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M","family":"Marlowe","sequence":"additional","affiliation":[{"name":"Quest Diagnostics Infectious Disease, San Juan Capistrano, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,1,28]]},"reference":[{"key":"2021042910361998600_CIT0001","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1056\/NEJMc2016321","article-title":"Swabs collected by patients or health care workers for SARS-CoV-2 testing","volume":"383","author":"Tu","year":"2020","journal-title":"N Engl J Med"},{"key":"2021042910361998600_CIT0002","doi-asserted-by":"crossref","first-page":"e2016382","DOI":"10.1001\/jamanetworkopen.2020.16382","article-title":"Comparison of unsupervised home self-collected midnasal swabs with clinician-collected nasopharyngeal swabs for detection of SARS-CoV-2 infection","volume":"3","author":"McCulloch","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2021042910361998600_CIT0003","doi-asserted-by":"crossref","first-page":"104417","DOI":"10.1016\/j.jcv.2020.104417","article-title":"Self-collection: an appropriate alternative during the SARS-CoV-2 pandemic","volume":"128","author":"Wehrhahn","year":"2020","journal-title":"J Clin Virol"},{"key":"2021042910361998600_CIT0004","article-title":"Self-collected anterior nasal and saliva specimens versus healthcare worker-collected nasopharyngeal swabs for the molecular detection of 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surveillance","volume":"2","author":"Jackson","year":"2015","journal-title":"Open Forum Infect Dis"},{"key":"2021042910361998600_CIT0011","article-title":"Longitudinal surveillance for SARS-CoV-2 RNA among asymptomatic staff in five Colorado skilled nursing facilities: epidemiologic, virologic and sequence analysis","author":"Quicke","year":"2020","journal-title":"medRxiv"},{"key":"2021042910361998600_CIT0012","article-title":"Asymptomatic transmission during the COVID-19 pandemic and implications for public health strategies","author":"Huff","year":"","journal-title":"Clin Infect Dis"},{"key":"2021042910361998600_CIT0013","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1056\/NEJMc2001737","article-title":"SARS-CoV-2 viral load in upper respiratory specimens of infected patients","volume":"382","author":"Zou","year":"2020","journal-title":"N Engl J Med"},{"key":"2021042910361998600_CIT0014","article-title":"Comparison of upper respiratory viral load distributions in 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