What to Do If You Get a Positive At-Home COVID-19 Test Result

A positive at-home COVID-19 test result may appear to answer one concerning question ("Do I have the virus?") but lead to others ("Now what?"). So it can help to know more about what a positive test means and what to do next if you have a fever, cough, loss of smell, or other COVID-19 symptoms.

It's just as important to understand the limits of a test. The availability of a fast, at-home COVID-19 test is helpful to anyone with symptoms or who's been exposed to the virus. But an at-home test can give incorrect results too. Notably, the rapid antigen at-home tests can give a false negative, saying you don't have COVID when you really do.

This article explains how at-home COVID-19 tests work, their accuracy, and what to do with a positive test result. It also presents precautions that are still necessary, even if you take frequent at-home tests.

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) authorization, since these tests have been evaluated by the FDA for reliability.

As of November 2022, there were 27 different at-home tests authorized by the FDA and sold over the counter, most of them antigen tests. All of these tests rely on a nasal swab from the nostrils and deliver results within 10 to 60 minutes. The most common time frame is 15 or 20 minutes.

These at-home tests are different from those mailed to a laboratory for analysis after you collect the sample at home. There are dozens of those PCR tests as well, with a longer delay until you receive results.

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. They look for viral DNA and are highly accurate, but take longer and are more expensive. PCR COVID-19 tests are considered the gold standard. 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.
  

Another type of test for COVID-19 is the antibody test, which requires a blood specimen. Self-tests do not detect antibodies, and 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 a Positive At-Home 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 tell the illnesses apart, 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. Keep in mind that COVID-19 variants may have mutations that make them undetectable by the specific 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.

In some cases when COVID-19 infection is unlikely, a confirmatory PCR test can be considered after a positive result on the antigen test.

False Negatives and At-Home COVID Tests

COVID-19 rapid antigen at-home tests can give a false negative result. It's possible when the viral load is low, such as when testing is done too soon after exposure and you don't yet have symptoms. That's why rapid antigen tests for COVID-19 are most accurate at least five days after exposure. Contact your healthcare provider for additional guidance.

Next Steps After a Positive COVID Test

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.

To reduce the chances of spreading COVID, the Centers for Disease Control and Prevention (CDC) recommends that you:

• Isolate at home until you've been fever-free for 24 hours (without taking fever-reducing medication) AND your symptoms are mild and improving.
• Take additional precautions for five days following isolation, such as wearing a well-fitting mask, keeping a distance from others, and washing your hands often.
  

If you need to isolate at home, 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.
• Don't share personal items like cups or towels.
• Improve ventilation in your home, if possible.

Positive Tests and Treatment

A positive at-home COVID-19 test doesn't necessarily require hospitalization or in-person treatment. Most cases of COVID-19 do not.

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 let them know if you are experiencing worsening symptoms or have any questions. While most people do not experience severe symptoms, some have mild symptoms initially that worsen several days later.

When to Seek Immediate Medical Care

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.

Your healthcare provider may recommend certain treatments approved for treating COVID-19, particularly if you have underlying conditions that increase your risk for severe complications.

For example, the antiviral treatment Paxlovid can be given in an outpatient setting and is effective at reducing hospitalization and death in people with COVID-19. People who may benefit include those who:

• Are aged 65 and older
• Live with a compromised immune system
• Have heart or lung diseases
• Are diagnosed with diabetes
• Live with obesity

This medication is most effective when given as early as possible, within five days of when symptoms begin.

The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit our coronavirus news page.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Centers for Disease Control and Prevention. Self-testing.
2. Food and Drug Administration. List of authorized at-home OTC COVID-19 diagnostic tests.
3. Centers for Disease Control and Prevention. Guidance for Antigen Testing for SARS-CoV-2 for Healthcare Providers Testing Individuals in the Community.
4. Food and Drug Administration. At-Home COVID-19 Antigen Tests-Take Steps to Reduce Your Risk of False Negative: FDA Safety Communication.
5. Centers for Disease Control and Prevention. Respiratory virus guidance.
6. Centers for Disease Control and Prevention. COVID-19 Treatments and Medications.

By Angela Ryan Lee, MD
Dr. Lee is an Ohio-based board-certified physician specializing in cardiovascular diseases and internal medicine.

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