Department of Global Health, School of Public Health, University of Washington, Seattle, WA.
Department of Global Health, School of Public Health, University of Washington, Seattle, WA.
Int J Infect Dis. 2022 Apr;117:287-294. doi: 10.1016/j.ijid.2022.02.009. Epub 2022 Feb 9.
This study assesses and compares the performance of different swab types and specimen collection sites for SARS-CoV-2 testing, to reference standard real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and viral culture.
Symptomatic adults with COVID-19 who visited routine COVID-19 testing sites used spun polyester and FLOQSwabs to self-collect specimens from the anterior nares and tongue. We evaluated the self-collected specimen from anterior nares and tongue swabs for the nucleocapsid (N) or spike (S) antigen of SARS-CoV-2 by RT-PCR and then compared these results with results from RT-PCR and viral cultures from nurse-collected nasopharyngeal swabs.
Diagnostic sensitivity was highest for RT-PCR testing conducted using specimens from the anterior nares collected on FLOQSwabs (84%; 95% CI 68-94%) and spun polyester swabs (82%; 95% CI 66-92%), compared to RT-PCR tests conducted using specimens from nasopharyngeal swabs. Relative to viral culture from nasopharyngeal swabs, diagnostic sensitivities were higher for RT-PCR and antigen testing of anterior nares swabs (91-100%) than that of tongue swabs (18-81%). Antigen testing of anterior nares swabs had higher sensitivities against viral culture (91%) than against nasopharyngeal RT-PCR (38-70%). All investigational tests had high specificity compared with nasopharyngeal RT-PCR. Spun polyester swabs are equally effective as FLOQSwabs for anterior nasal RT-PCR testing.
We found that anterior nares specimens were more sensitive than tongue swab specimens or antigen testing for detecting SARS-CoV-2 by RT-PCR. Thus, self-collected anterior nares specimens may represent an alternative method for diagnostic SARS-CoV-2 testing in some settings.
本研究评估并比较了不同拭子类型和采集部位在 SARS-CoV-2 检测中的表现，以参考实时逆转录聚合酶链反应（RT-PCR）和病毒培养的标准。
患有 COVID-19 的有症状成年人在常规 COVID-19 检测点使用纺聚酯和 FLOQ 拭子自行从前鼻和舌采集标本。我们通过 RT-PCR 评估了来自前鼻和舌拭子的自采集标本的 SARS-CoV-2 核衣壳（N）或刺突（S）抗原，并将这些结果与护士采集的鼻咽拭子的 RT-PCR 和病毒培养结果进行比较。
使用 FLOQ 拭子（84%；95%CI 68-94%）和纺聚酯拭子（82%；95%CI 66-92%）采集的前鼻拭子标本进行的 RT-PCR 检测的诊断灵敏度最高，与鼻咽拭子进行的 RT-PCR 检测相比。与鼻咽拭子的病毒培养相比，前鼻拭子的 RT-PCR 和抗原检测的诊断灵敏度较高（91-100%），而舌拭子的灵敏度较低（18-81%）。前鼻拭子的抗原检测对病毒培养的灵敏度（91%）高于对鼻咽 RT-PCR（38-70%）。所有研究性检测与鼻咽 RT-PCR 相比特异性均较高。纺聚酯拭子在前鼻 RT-PCR 检测中的效果与 FLOQ 拭子相当。
我们发现，在前鼻拭子标本中，通过 RT-PCR 检测 SARS-CoV-2 的灵敏度高于舌拭子标本或抗原检测。因此，在某些情况下，自我采集的前鼻标本可能代表一种替代的 SARS-CoV-2 诊断检测方法。
