How Accurate Is a Patient’s Home Rapid Test Result? (2024)

06 March, 2024

Many COVID-19 cases are currently diagnosed outside of the health care setting, typically with use of at-home rapid antigen tests. Multiple studies have confirmed that although antigen tests are less sensitive than “gold standard” polymerase chain reaction tests, they have good operating characteristics among acutely symptomatic persons, with an extremely low false-positive rate (Lee, November 2021; Chu, April 2022; Soni, July 2023). What is less clear, however, is whether these tests remain highly accurate in the hands of outpatients in the “real world” versus when used by health professionals.

This question was the subject of a large study at a single community testing site in Baltimore, where 953 patients presenting for COVID-19 testing underwent clinician-collected swabs for both rapid (BinaxNOW) and PCR testing. After clinician tests were collected, patients then performed and interpreted their own rapid test. The sensitivity of clinician and self-collected rapid testing was very good and relatively similar at 88.2% (clinician) vs. 83.9% (patient); notably, sensitivity was much lower in asymptomatic cases (63% [clinician] vs. 52% [self]) as compared to symptomatic cases (90% [clinician] vs. 88% [self]). Overall, very high and concordant specificities were observed: 99.6% (clinician) vs. 99.8% (patient). Interestingly, ~5% of positive self-collected rapid tests were read by the patient as negative yet were deemed to be positive results by the clinician team when re-read.

Conclusion: This study supports that self-collected rapid tests show similar sensitivity and specificity to those performed by clinicians. In particular, false-positive testing is exceedingly uncommon, though false negatives occur among asymptomatic persons — such cases tend to have high cycle threshold values, suggesting lower viral loads. Inaccurate interpretation of positive antigen tests by some patients indicates a role for targeted education to improve their use in nonclinical settings.

How Accurate Is a Patient’s Home Rapid Test Result? (2024)

FAQs

How Accurate Is a Patient’s Home Rapid Test Result? ›

The sensitivity of clinician and self-collected rapid testing was very good and relatively similar at 88.2% (clinician) vs. 83.9% (patient); notably, sensitivity was much lower in asymptomatic cases (63% [clinician] vs. 52% [self]) as compared to symptomatic cases (90% [clinician] vs. 88% [self]).

How accurate are COVID rapid at home tests? ›

At-home COVID-19 tests produce a high percentage of false negative results because they are less sensitive than PCR tests. PCR tests are accurate nearly 99% of the time. Antigen tests don't pick up all COVID-19 infections, but timing is also important.

How likely is a false positive at home rapid COVID test? ›

The percentage of rapid antigen tests with false positive results is reported to be less than 1%.

How accurate is the rapid response COVID test? ›

Highest sensitivities, or highest true positive proportions, were observed within groups of people who: conducted their test in supervised settings (86.7%), were symptomatic (73.9%) used mid-turbinate nasal specimens, i.e., sample taken just from further up the nostrils inside the nose (77.8%)

What is the most accurate COVID home test? ›

iHealth COVID-19 Antigen Rapid Test

It easily slid into our best overall spot because its results are clearer than most, and it has minimal components, which makes testing a breeze. The test requires inserting about half an inch of a simple nasal swab into your nostril.

Does a faint line mean less COVID? ›

If you test positive—faint or not—it means that you have infectious COVID-19 particles in your body, Dr. Russo says. But how dark the line is does give you a little insight into what's going on, Dr. Adalja says. “The less dark, the line is, the less viral material that is present,” he says.

Can I have COVID and test negative? ›

A negative COVID-19 test means the test did not detect the virus, but this doesn't rule out that you could have an infection. If you used an antigen test, follow FDA recommendations for repeat testing. If you have symptoms: You may have COVID-19 but tested before the virus was detectable.

How reliable is a positive home COVID test? ›

The sensitivity of clinician and self-collected rapid testing was very good and relatively similar at 88.2% (clinician) vs. 83.9% (patient); notably, sensitivity was much lower in asymptomatic cases (63% [clinician] vs. 52% [self]) as compared to symptomatic cases (90% [clinician] vs. 88% [self]).

How to get rid of COVID fast? ›

Take Over-The-Counter Medications

Antivirals are most effective if started within the first 48 hours of symptoms. If used accurately, they can shorten the duration of illness by about 24 hours and decrease the risk of complications, especially in high-risk populations.

Do you always have a fever with COVID? ›

Low-grade fever seems to be one of the more common early markers of COVID-19, Kline said, but not everyone will have a fever. Other potential symptoms include muscle aches, headaches, loss of appetite, and loss of taste or smell. Symptoms can appear between two and 14 days after exposure.

When are you most contagious with COVID? ›

When is COVID-19 most contagious? COVID-19 is thought to be most contagious through day 5. This is largely due to viral shedding (when the virus in your body is released into the environment). The highest levels of viral shedding occur during and after symptom onset.

What is the failure rate of rapid Covid tests? ›

Diagnostic accuracy of SARS-CoV-2 antigen tests

A Cochrane review [13] of rapid antigen tests published in 2022, based on the pre-omicron era, found an average sensitivity of 54.7 % for people testing without symptoms, 49.6 % for people who are not known contacts.

What is the incubation period for COVID? ›

People with COVID-19 have a wide range of symptoms ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. Symptoms may start as mild, and some people will progress to more severe symptoms.

How long after COVID exposure will you test positive? ›

If you have symptoms, test right away. Wait five days to test after exposure if you do not have symptoms. If you have symptoms but test negative, you should test again after 48 hours.

What are the current COVID symptoms? ›

Symptoms of COVID-19

a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours. a loss or change to your sense of smell or taste. shortness of breath. feeling tired or exhausted.

How long will I test positive for COVID after having it? ›

Key Takeaways. If you get COVID-19, you may continue to test positive even after you're feeling better. Some people who recover from COVID may test positive for weeks or even months after they were sick.

How common is a false negative COVID test? ›

If you wait a few days, the timing might be right to catch COVID but you are too late for flu and RSV.” While a 66% false negative rate may seem high for a COVID test, Larremore notes that the tests are designed to identify folks who have a high viral load and are, thus, most likely to infect others.

Do at-home COVID tests work? ›

A: Yes. The FDA recommends repeat testing following a negative COVID-19 antigen test result whether or not you have COVID-19 symptoms. COVID-19 antigen tests are less accurate than molecular tests and may not detect the SARS-CoV-2 virus early in an infection or in people who do not have COVID-19 symptoms.

What should I do if I test negative for COVID-19 but still experiencing symptoms? ›

You could still have COVID-19 and your initial test did not detect the virus, or you may have another illness. Take public health precautions to prevent spreading an illness to others. Test again after 48 hours. Consider getting a laboratory-based molecular COVID-19 test or call your health care provider.

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