To make it even more convenient, the Food and Drug Administration has granted emergency use authorization to several at-home tests and collection kits—and, some don’t require a nasal swab at all.  At-home COVID-19 tests and kits bring several advantages and disadvantages, says Dr. Gary Procop,MD, vice chair at the Pathology Education, Pathology and Laboratory Medicine Institute at Cleveland Clinic.   “In my mind, the optimal use for these tests is when somebody feels like they have signs and symptoms of COVID-19, and they could be tested in their home without having to go out and endanger other people,” he says. At-home testing also saves on resources, like personal protective equipment.  Tests are available both over the counter and by prescription only. When you take an at-home test, you collect your own specimen—either by nasal swab or saliva collection. Depending on the type of test, you could have your results in minutes or within a few days if you have to send the sample to a lab.  Collecting your own specimen is one of the biggest challenges with the test, Procop says, though most of the at-home testing companies have created easy-to-use instructions and videos. And, the Centers for Disease Control and Prevention (CDC) stresses that following these manufacturers’ instructions. But, how accurate are at-home COVID-19 tests? There are a few things you should know before you try one. 

How accurate are at-home COVID-19 tests?

At-home tests fall into the “moderately sensitive category,” Procop says, “They’re good tests, but they’re not as good as the tests we do in the laboratory.”  Most are antigen tests, which have been shown to be less accurate than PCR tests. So,  Dr. Daniel Fagbuyi, MD, emergency room physician and Obama Administration biodefense and global health security expert, worries at-home testing might give people a false sense of security.  “People need to know that this is a moment in time when they take that test,” he explains. Tests check for the presence of the virus protein in your system. But, if you take the test too soon after being exposed, you could get a negative result even if you’re truly positive.  At-home test accuracy depends on whether or not someone has COVID-19 symptoms, according to a study co-authored by Procop and published in the Cleveland Clinic Journal of Medicine in February. The research revealed that positive results were more likely to be accurate for symptomatic individuals, but less so for asymptomatic people. Negative results, whether a person is symptomatic or asymptomatic, might not be as accurate.  “If you have signs and symptoms of COVID-19 and your test is negative, you should think about getting it followed up with a more sensitive test, because it could be a false negative,” Procop explains, and if you’re asymptomatic and test positive, it could be a false positive.  No matter what your results are, Fagbuyi says you still need to wear masks, social distance and avoid being around others if you’re sick.  Here’s a look at some of the at-home COVID-19 tests and kits, including how they work and what you need to know before taking one: 

At-home COVID tests

Ellume COVID-19 Home Test

The Ellume self-test includes a sterile nasal swab, dropper, processing fluid and an analyzer that connects to your smartphone. The company says results are available in 15 minutes on the company’s app. According to the Cleveland Clinic study, the test detected 94.6% of the positive specimens. 

Everlywell COVID-19 Test Home Collection Kit

With the Everlywell COVID-19 Test Home Collection Kit, you take an online questionnaire about your symptoms, collect your own sample using a nasal swab, and then ship it overnight to a lab. Results are ready within 24 to 48 hours of the lab receiving the sample and accessible digitally. If you test positive, you have access to a telehealth consultant, too. Cost is $109. 

Hims & Hers COVID-19 Saliva Test

Hoping to avoid a nasal swab? The Hims & Hers COVID-19 test is a great option, as it’s saliva-based. To start, you’ll need to answer a few questions about your health, and then a medical professional will help you decide if the test is right for you. Next, you’ll collect your saliva in a tube and ship it to the lab. Results are available online three to five days later. Cost is $150. 

Pixel by Labcorp Self-Collection Kit

The Pixel by Labcorp kit is available for free to anyone who meets the company’s clinical guidelines: you have mild symptoms of COVID-19, have been exposed to someone with the virus, live or work in a group setting, or were asked to be tested by a health professional. Otherwise, the kit costs $119. You’ll receive a nasal swab and instructions for collecting your sample. Once the lab receives the specimen, you can access the results online in about one to days. 

Phosphorous COVID-19 At-Home Saliva Test

To order the Phosphorus at-home PCR test, you’ll start with an online health questionnaire. When you receive the kit, collect your saliva sample using the instructions provided and ship it back to them. Your results will be ready within about 72 hours of the lab receiving your sample. Cost $49 with insurance or $119 without. 

Vault Health COVID-19 Test Kit

Like other at-home COVID-19 tests, Vault Health’s kitincludes an online questionnaire about your symptoms, exposure and other health details. The saliva collection test is performed via a Zoom call with a test supervisor who will guide you through the process. Then, you’ll send in your sample and receive results in 24 to 48 hours from it being received by the lab. Cost is $119.

Vitagene COVID-19 Saliva Test Kit

When you receive your COVID-19 test kit from Vitagene, you first need to register it online. Next, use the instructions and tube provided to collect your saliva sample, and then ship it back to the company. Once received by the lab, results will be ready in about 72 hours. Cost is $117.  Next, read about how to know if you need a COVID-19 test. 

Sources

Dr. Daniel Fagbuyi, MD, emergency room physician, Obama Administration biodefense and global health security expertDr. Gary Procop, MD, vice chair, Pathology Education, Pathology and Laboratory Medicine Institute, Cleveland ClinicCenters for Disease Control and Prevention (CDC): At-Home Testing CDC:Overview of Testing for SARS-CoV-2 (COVID-19)Cleveland Clinic Journal of Medicine:Home testing for COVID-19: Benefits and limitationsEllume:How It Works Everlywell:COVID-19 Test At-Home Collection Kit Hims & Hers:COVID-19 Saliva TestPixel by Labcorp:Self-Collection KitPhosphorous:COVID-19 RT-qPCR At-Home Saliva TestVault Health:COVID-19 Test Kit Vitagene: COVID-19 Saliva Test Kit  Are At Home COVID Tests Accurate  - 90