{"doi":"10.1016/j.ijid.2022.02.009","title":"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","abstract":"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 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.","journal":"International Journal of Infectious Diseases","year":2022,"id":272436,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9653,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":634596,"name":"Meagan J. Bemer","orcid":"0000-0003-0009-7589","position":1,"is_corresponding":false},{"id":654207,"name":"Kate B. Heller","orcid":null,"position":2,"is_corresponding":false},{"id":562260,"name":"Allison Meisner","orcid":"0000-0001-5177-7635","position":3,"is_corresponding":false},{"id":939494,"name":"Zarna Marfatia","orcid":null,"position":4,"is_corresponding":false},{"id":938965,"name":"Elena A. Rechkina","orcid":"0000-0001-8636-4048","position":5,"is_corresponding":false},{"id":402425,"name":"Leah R. Padgett","orcid":"0000-0001-9295-9689","position":6,"is_corresponding":false},{"id":938966,"name":"Charlotte L. Ahls","orcid":"0009-0007-1416-6289","position":7,"is_corresponding":false},{"id":939495,"name":"Douglas Rains","orcid":null,"position":8,"is_corresponding":false},{"id":866208,"name":"Linhui Hao","orcid":"0000-0002-7325-1009","position":9,"is_corresponding":false},{"id":245056,"name":"Tien-Ying Hsiang","orcid":"0000-0002-4316-4561","position":10,"is_corresponding":false},{"id":404665,"name":"Gerard A. Cangelosi","orcid":"0000-0003-0006-6520","position":11,"is_corresponding":false},{"id":108342,"name":"Alexander L. Greninger","orcid":"0000-0002-7443-0527","position":12,"is_corresponding":false},{"id":913424,"name":"Jason L. Cantera","orcid":"0000-0001-7665-5458","position":13,"is_corresponding":false},{"id":494535,"name":"Allison Golden","orcid":"0000-0001-6891-5176","position":14,"is_corresponding":false},{"id":913425,"name":"Roger Peck","orcid":"0000-0003-1085-2883","position":15,"is_corresponding":false},{"id":590023,"name":"David S. Boyle","orcid":"0000-0003-4019-9037","position":16,"is_corresponding":false},{"id":108916,"name":"Michael Gale","orcid":"0000-0002-6332-7436","position":17,"is_corresponding":false},{"id":490093,"name":"Paul K. Drain","orcid":"0000-0002-9569-4097","position":18,"is_corresponding":false},{"id":800811,"name":"Michalina A. Montaño","orcid":"0000-0003-2872-1929","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-19T00:27:47.926496Z","pmid":"35149246","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}