Evidence map›Paper›PMID 42243943›Full record

SynthesisVirology journal2026

Sensitivity of gargle samples compared to swabs for SARS-CoV-2 detection with nucleic acid amplification testing: a systematic review and meta-analysis.

Iryna Kayda, Kwana Lechiile, Mai-Lei Woo Kinshella, Jeffrey N Bone, Pascal M Lavoie, David M Goldfarb

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in Virology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Iryna Kayda *School of Medicine, University of Western Australia, Perth, Australia.
Kwana Lechiile *University of Botswana, Gaborone, Botswana.
Mai-Lei Woo KinshellaDepartment of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada.
Jeffrey N BoneDepartment of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada.
Pascal M LavoieDepartment of Pediatrics, University of British Columbia, Vancouver, Canada.
David M GoldfarbDepartment of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada. david.goldfarb@cw.bc.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGargle sampling emerged as a novel method for diagnostic testing during the coronavirus disease 2019 (COVID-19) pandemic, yet uncertainty remained about its performance when compared with conventional sampling methods.

objectiveTo evaluate the performance of self-collected gargle samples compared to traditional healthcare worker (HCW)-collected upper respiratory tract swabs for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection with nucleic acid amplification testing (NAAT).

methodsWe conducted a systematic review (PROSPERO registration: CRD42022312628) to (1) estimate sensitivity of gargle sampling, (2) estimate the difference in sensitivity between gargle and swab methods, and (3) understand how various testing contexts may impact gargle sensitivity. MEDLINE, EMBASE, Web of Science, Global Index Medicus, and preprint servers were searched. Studies reporting primary data and investigating COVID-19 diagnostic performance of self-collected gargle samples compared to HCW-collected swabs tested using NAAT were included. Quality assessment was performed, and random effects meta-analysis was conducted to estimate the pooled gargle sensitivity and mean difference in sensitivity between gargle and swab methods.

resultsSearches identified 1453 results with 32 studies included. Meta-analysis pooled 34 gargle-swab comparisons. Gargle sensitivity was estimated to be 92.2% (95% confidence interval: 89.6% to 94.2%), and 3.3% (0.4% to 6.3%) less sensitive than swab collection. Gargle sensitivity was greater than 87.0% across diverse patient characteristics, settings, type or volume of gargle liquid, length of gargling time, wait time prior to gargling, and reference swab type used. Greatest sensitivities were observed when gargle sampling for 30 s or greater using 5-9 mL of saline. Gargle sensitivity of 93.0% (87.8% to 96.1%) was observed when there was no required wait time, and 90.1% (87.0% to 92.5%) when compared to combined nasopharyngeal and oropharyngeal swabs.

conclusionGargle sampling may be a sensitive, alternative method for SARS-CoV-2 detection across various testing contexts, and its implementation has potential to reduce barriers associated with HCW-collected swabs, that may be challenging to collect.

Indexed as

COVID-19COVID-19 Nucleic Acid TestingNucleic Acid Amplification TechniquesSARS-CoV-2Specimen HandlingHumansNasopharynxSensitivity and SpecificityCOVID-19DiagnosisGargle samplesMolecular testingSARS-CoV-2Swab

Identifiers

PMID42243943
PMCPMC13459294

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.