Combined Self-Collected Anterior Nasal and Oropharyngeal Specimens versus Provider-Collected Nasopharyngeal Swabs for the Detection of SARS-CoV-2
Salika M. Shakir, Adam P. Barker, David R. Hillyard, Norbert Gilmore, J. W. Barrett, Renato de Abreu Orlandi, Kimberly E. Hanson
Abstract
The U.S. Food and Drug Administration (FDA) and Centers for Disease Control interim guidelines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing list the patient self-collected anterior nares swab (ANS) as an acceptable alternative to the standard health care provider (HCP)-collected nasopharyngeal swab (NPS) (1, 2). Self-collected ANS minimizes HCP exposure to infectious aerosols, thus reducing the need for high-level personal protective equipment. Self-collection using ANS may also be more comfortable for the patient. However, published reports have observed variable ANS sensitivities compared to NPS (3–5). We previously observed that self-collected ANS missed 15% of positive detections compared to NPS or saliva (6) and hypothesized that self-collected swabs from multiple anatomic sites may improve diagnostic sensitivity.