ArticleAccess microbiology2026
Comparison of self-collected oral-nasal and mid-turbinate swabs to healthcare worker-collected nasopharyngeal swabs for the detection of SARS-CoV-2: a paired clinical evaluation.
Article in Access microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Accurate detection of respiratory viruses is essential for infection control, patient management and public health response. Nasopharyngeal swabs (NPS), collected by healthcare workers (HWC-NPS), remain the gold standard for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) detection but require trained personnel and can be uncomfortable for patients. Self-collected swabs, such as oral-nasal swabs (SC-ONS) and mid-turbinate swabs, offer scalable alternatives suitable for mass testing. Previous mid-turbinate swab designs included a plastic stopper and were not compatible with automated laboratory testing. This study compared the performance of (i) SC-ONS, (ii) an automation-friendly, redesigned version of mid-turbinate swab (SC-MTS) and (iii) HWC-NPS in detecting SARS-CoV-2. Between April and June 2022, paired NPS, ONS and MTS samples were collected from 100 participants at a Coronavirus disease 2019 (COVID-19) assessment centre in Hamilton, Ontario. Samples were tested for SARS-CoV-2 by reverse-transcriptase PCR. Compared to HWC-NPS, SC-ONS demonstrated 82.1% sensitivity and 100% specificity, while SC-MTS showed 75.0% sensitivity and 100% specificity. Agreement with HWC-NPS was strong for both SC-ONS (κ=0.863) and SC-MTS (κ=0.804). Agreement between SC-ONS and SC-MTS was nearly perfect (κ=0.944). Cellular material yields as well as SARS-CoV-2 viral loads were lower for self-collected swabs than HWC-NPS, while viral load comparisons revealed no significant difference between SC-ONS and SC-MTS. Our study aligns with previous work demonstrating the use of self-collected mid-turbinate swabs for the detection of respiratory viruses, while also demonstrating the compatibility of the newly designed swabs with automated laboratory instruments. Our results, while conducted in a relatively small sample, suggest that self-collected ONS and MTS are reliable alternatives to HWC-NPS, offering practical, less invasive, automation-friendly options for large-scale respiratory virus surveillance and pandemic preparedness.
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