Performance of anterior nares and tongue swabs for nucleic acid, Nucleocapsid, and Spike antigen testing for detecting SARS-CoV-2 against nasopharyngeal PCR and viral culture

作者：Michalina A. Montaño, Meagan J. Bemer, Kate B. Heller, Allison Meisner, Zarna Marfatia, Elena A. Rechkina, Leah R. Padgett, Charlotte L. Ahls, Douglas Rains, Linhui Hao, Tien-Ying Hsiang, Gerard A. Cangelosi, Alexander L. Greninger, Jason L. Cantera, Allison Golden, Roger Peck, David S. Boyle, Michael Gale, Paul K. Drain · 发表于：International Journal of Infectious Diseases · 年份：2022 · DOI：10.1016/j.ijid.2022.02.009 · 被引用次数：11 · 研究领域：SARS-CoV-2 detection and testing、Dental Research and COVID-19、Respiratory viral infections research

OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: We fou...