The availability of at-home COVID-19 testing is a very convenient option for anyone with symptoms of COVID-19 or exposure to the virus. A COVID-19 test should be taken regardless of vaccination status if you are experiencing symptoms such as fever, cough, shortness of breath, runny nose, and loss of smell. You should also be tested if you have been within 6 feet of a person with confirmed or suspected COVID-19 for more than 15 minutes.1
While at-home tests are convenient and can be reassuring, they can also give incorrect results. It's important to know the likelihood of this and what to do with your results. Also know that frequent at-home testing will not prevent you from contracting the virus, and following precautions is still necessary.
This article discusses the different types of at-home COVID-19 tests, their accuracy, and what to do with a positive test result.
COVID test
Which COVID Test Is More Accurate?
At-home COVID tests can be purchased from a pharmacy, retail store, or online. Look for a label denoting Food and Drug Administration (FDA) approval, since these tests have been evaluated by the FDA for reliability.2
Several variations of at-home diagnostic tests exist. Specimens may be collected from the nostrils or from saliva. Depending on the test, results can be provided within minutes at home, or the test can be mailed to a laboratory for analysis.
Regardless of the type of test, at-home tests are a great option for those experiencing COVID-19 symptoms who want to test before going to an in-person testing center.
Types of COVID-19 Tests
Diagnostic COVID-19 tests are meant for diagnosing an active COVID-19 infection. They require specimen collection from the nose or saliva. The two types of diagnostic tests are:
PCR (polymerase chain reaction) tests, also known as molecular tests, look for viral DNA and are highly accurate, but they take longer and are more expensive. PCR tests are considered the gold standard test for COVID-19. Most at-home PCR tests require mailing the sample to a lab, with results in 24–48 hours.
Antigen tests, also known as rapid tests, look for viral proteins, give results within minutes, and are less expensive. However, antigen tests are less accurate than PCR tests and have more false negative results. Depending on the likelihood of infection, a negative antigen test may need to be followed up with a PCR test.
Another type of test for COVID-19 is the antibody test, which requires a blood specimen. This test should not be performed to diagnose an active COVID-19 infection. Antibody tests demonstrate prior infection by testing for antibodies, which are proteins made by the body that remain in the blood after infection.
Some antibody tests may be positive in vaccinated people, since their bodies have also created certain antibodies.
Is Your Test Result Accurate?
During cold and flu season, symptoms like nasal congestion and fatigue don't necessarily mean COVID-19. But it can be challenging to differentiate among the illnesses, since they share certain symptoms.
A negative result from an at-home test can be very reassuring but know that certain situations and types of tests may require repeat or follow-up testing. As with any kind of medical testing, false negatives and false positives can happen. These decrease the accuracy of a test.
A false negative test means that the test result shows up as negative when the person actually does have COVID-19. This situation is more common with antigen tests, compared with PCR tests.
False negatives can happen due to improper specimen collection, which is why it's important to perform the test exactly as instructed by the kit. A false negative result can also occur when viral load is low, such as when testing is done too soon after exposure. Additionally, certain strains of coronavirus may have mutations that make them undetectable by the test.
A false positive test means that the test shows a positive result when the person is not actually infected with COVID-19. False positive results are much less common and can happen due to a problem with the test kit itself. They can also occur for a period of time after a person has recovered from COVID-19.
A positive result should not be assumed to be a false positive, and action must be taken when a positive result is received.
Next Steps After Receiving a Positive Test Result
At-home COVID tests are very specific, making false positive rates low. For this reason, a positive test result should not be considered a false positive, and you should take steps after receiving a positive test to decrease the chances of passing the virus to other people.
Steps you should take to protect others include:
Isolate: Stay home and avoid contact with other people.
Contact your healthcare provider: You should inform your healthcare provider of your positive test result. Contact them first either by phone or by electronic means.
Receive care from your provider: Many healthcare providers are now offering the option of telemedicine, which is a great way to visit with a healthcare provider without exposing anyone else to the virus. If you require medical care in person, call ahead to inform the office that you have tested positive for COVID-19.
Informing Your Contacts About Exposure
When you receive a positive COVID-19 test result, it's extremely important to inform the people you have been in contact with. Then they can have their own testing done, monitor for symptoms, and quarantine to minimize the chances of passing the virus on to more people.
People who are fully vaccinated do not need to quarantine after exposure, but according to the Centers for Disease Control and Prevention (CDC), they should be tested within five to seven days, and they should wear a face mask in public until receiving a negative result.1
In some cases when COVID-19 infection is unlikely, a confirmatory PCR test can be considered for a positive antigen test. The CDC recommends that confirmatory PCR testing may be done for those who are fully vaccinated or have no known exposure to anyone with COVID-19.3 However, in the meantime, you should still isolate until the diagnosis is clarified.
Isolating and Treatment
After receiving a positive COVID-19 test, isolation is key to preventing the spread of the virus. You should isolate regardless of whether you have symptoms of infection.
To isolate properly, take the following measures:
Stay home unless you require medical care.
If you live with others, try to avoid contact as much as possible by staying in a separate room, and use a separate bathroom, if possible.
Avoid contact with pets, since they can contract COVID-19.
Wash hands frequently and disinfect high-touch surfaces like doorknobs, handles, light switches, and countertops.
If you have COVID-19 with no symptoms, you should isolate for 10 days. Those with COVID-19 symptoms should isolate for at least 10 days from the start of symptoms, be fever free without fever-reducing medications for 24 hours, and have improving symptoms.4
Most cases of COVID-19 do not require hospitalization or in-person treatment. At-home care should include lots of rest and plenty of fluids to prevent dehydration. Over-the-counter fever-reducing medication, such as Tylenol (acetaminophen) and NSAIDs like Advil or Motrin (ibuprofen) can lower fever and ease body aches and headache. Cold and flu medications like decongestants and expectorants can also help relieve symptoms.
Stay in contact with your healthcare provider and contact them if you are experiencing worsening symptoms or have any questions. While most people do not experience severe symptoms, those who do often have mild symptoms initially that worsen several days later.
Your healthcare provider may recommend certain treatments recently approved for treating COVID-19, particularly if you have underlying conditions that increase your risk for severe complications.
For example, monoclonal antibody treatments can be given in an outpatient setting and are effective at reducing hospitalization and death in people with COVID-19. People aged 65 and older and people with a compromised immune system, heart disease, lung disease, diabetes, or obesity can benefit from monoclonal antibody treatment. These medications are most effective when given early in the course of illness.5
If you experience concerning symptoms such as shortness of breath, chest pain, and blue or gray skin or lips, you should seek medical care immediately.