Over the last two years, the ways in which we are able to diagnose COVID-19 have rapidly evolved. One of the more recent developments is the availability of at-home tests for people to collect a specimen on their own and receive a positive or negative result.
Emil Lesho, DO, an infectious disease specialist with Rochester Regional Health, explains how the tests were developed and how to use one.
How do at-home COVID-19 tests work?
At-home tests – also called home tests or self tests – are done using two different methods: antigen or molecular testing.
Antigen testing uses a sample to detect the presence of a specific viral antigen. Molecular testing uses a sample to detect the genetic material of the virus. A positive result in either test indicates an infection.
Each test kit contains materials and instructions for a person to collect a sample – usually via a nasal swab or saliva specimen. The sample is then left to sit until results appear. With most at-home tests, this is within 15-30 minutes.
Some tests require a second swab or sample within a certain amount of time to confirm the results.
Tests sold at pharmacies and other retail locations have been approved for sale by the FDA. A list of approved tests is available online.
How do I use one?
There are currently 14 FDA tests given emergency use authorization available through over-the-counter purchase at most pharmacies and retail stores.
- CareStart COVID-19 Antigen Home Test
- Insert the swab into your nose until you reach resistance. Swirl 3-5 times, wait 3-4 seconds, then remove from the nostrils. Place the swab into the provided extraction vial and follow the directions. Results are ready in 10 minutes.
- InteliSwab COVID-19 Rapid Test
- Swirl the swab gently inside your nostril 15 times in each direction, then place it into the test tube and swirl it 10 more times. It takes about 30 minutes for the results.
- BinaxNOW COVID-19 Antigen Home Test
- Two swabs are included. Swirl the swab inside your nostril to get a sample and place it onto the provided test card. A positive or negative result will appear. Repeat the process within 36 hours using the second swab to confirm the result.
- QuickVue At-Home COVID-19 Test
- Swab both nostrils 3-4 times using the same swab. Place the swab into the tube for 1 minute, then throw the swab away. Take the provided test strip and place into the tube as directed. Results will be ready in 10 minutes.
- Ellume COVID-19 Home Test
- Open the kit and download the Ellume Home Test app. The testing kit will sync up to your phone through Bluetooth. Open the app and follow the on-screen instructions. Results will be ready in 15 minutes.
- BD Veritor At-Home COVID-19 Test
- Open the kit and download the BD Veritor At-Home COVID-19 Test app. You can use the provided nasal swab and transfer it to the test stick. Results are ready in 15 minutes. Using the app, you can take a photo of the test stick’s results to ensure results are accurate.
- Lucira CHECK-IT COVID-19 Test Kit
- This test reader requires two AA batteries, which are included in the kit. The person using it needs to swab the inside of each nostril 5 times, then place the swab into the provided vial and swirl 15 minutes. Results are ready in 30 minutes or less.
- Cue COVID-19 Test for Home
- Using this test requires the person to download and create an account for the Cue Health app. Swab the inside of your nostril and place the sample inside the cartridge. The cartridge will then be placed inside the reader and the test will be conducted. Results should be ready in 20 minutes.
- ACON Laboratories Flowflex COVID-19 Home Test
- Swab the inside of each nostril, rotating the swab 5 times. Put the swab into the provided tube and swirl for at least 30 seconds. Squeeze the bottom of the tube to mix the sample with the fluid, screw the cap onto the tube, and put 4 drops of the mixture into the test cartridge. Results are ready in 15-30 minutes.
- Celltrion DiaTrust COVID-19 Home Test
- This is labeled for use at home via prescription. Swab inside each nostril for 7-10 seconds, then place the swab into the provided test tube and move up and down several times to ensure the collected sample gets into the tube. Place the filter cap on top of the tube and squeeze 3 drops onto the sample well. Results will be ready in 15 minutes; do not read after more than 20 minutes.
- iHealth COVID-19 Rapid Test
- Swab the inside of the nostril 5 times each - going no more than 3/4 inches up the nostril. Place the swab into the sample tube and swirl 15 times, then remove the swab - squeezing the sides of the tube as you remove it. Squeeze 3 drops of the fluid in the tube onto the sample card. Results will be ready in 15 minutes.
- InBios SCoV-2 Detect Rapid Self-Test
- Wash your hands before opening the kit. Place the swab into a nostril and swirl for at least 15 seconds. Repeat with the other nostril, then press the swab firmly into the sample cassette. Add 8 drops of the provided Lysis buffer fluid. Results will be ready in 20 minutes. Do not read after 25 minutes.
- MaximBio ClearDetect COVID-19 Antigen Home Test
- Wash your hands, then open the package and place the tube in the provided holder. Open the package containing the swab, then insert into approximately 1/2 inch into a nostril and swirl 5 times for at least 15 seconds. Repeat with the other nostril, then dip the swab into the tube repeatedly for 30-60 seconds. Open the test strip pouch, lower the strip into the tube, and screw on the cap. Wait for 15 minutes and read the results.
- SD Biosensor Standard Q COVID-19 ag Home Test
- First, wash your hands. Open the kit, remove the solution tube from the pouch, and press the tube into the designated stand on the box. Swab the inside of each nostril, rotating 10 times in each nostril. Place the swab into the solution tube, then swirl the swab 10 times in the tube while squeezing the bottom of the tube. Pull the swab out, press the cap firmly onto the top of the tube, then add 4 drops of the fluid to the sample well. Results will be ready in 15 minutes.
“Each test has gone through rigorous testing and reviews to ensure it is as accurate as possible for people using it at home,” Dr. Lesho said.
How accurate are they?
All kits are at least 84 percent accurate when it comes to positive test results.
When it comes to negative test results, accuracy rates are 91 percent or higher.
Even with these high accuracy rates, using the tests too early or too late could mean getting a false negative. You should get a PCR test done at a doctor’s office, urgent care, or other healthcare location to be more certain.
“The best method to prevent COVID-19 infection is to get vaccinated against the virus,” Dr. Lesho said.
How much do they cost?
Typically the cost ranges from $15 - 130.
Depending on whether your doctor prescribes an at-home test for you, the cost may vary.
What do I do if I get a positive result?
If you get a positive test result on an at-home COVID-19 test, you should immediately call your primary care provider or an urgent care and schedule another test.
Isolate yourself from others as a precaution in the meantime.
The gold standard for COVID-19 tests are PCR tests. Most employers or organizations require a PCR test result.
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