Swab the Throat as Well as the Nose? The Debate Over the Best Way to Test for SARS-CoV-2

פוסט זה זמין גם ב: עברית

Rita Rubin, MA

JAMA. Published online January 11, 2023. doi:10.1001/jama.2022.23311

That’s the most recent advice from the US Food and Drug Administration (FDA), posted in December 2022, about how often asymptomatic people should take rapid antigen tests to make sure they’ve tested negative for COVID-19.

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iStock.com/Pascal Skwara

“Not helpful, since [infected] people transmit during this time!” California Institute of Technology chemist Rustem Ismagilov, PhD, director of the Jacobs Institute for Molecular Engineering for Medicine, wrote in an email to JAMA.

Ismagilov’s research suggests the reason that it might take so long for some infected people to test positive with nasal swabs is that, at the beginning, SARS-CoV-2 viral loads are higher in the throat.

As of December, the FDA hadn’t authorized any rapid test that involves a throat swab, spokesperson James McKinny told JAMA in an email.

Yet, some studies have found that swabbing both the nose and the throat increases test sensitivity—from a little more to a lot more—than nasal swabs alone. However, other studies haven’t found an added benefit from swabbing both sites.

How It Started

As Omicron began to take off a year ago, videos posted on social media suggested that throat swabs or throat and nasal swabs combined might be better at detecting the newest SARS-CoV-2 variant.

At the time, proponents had little more than anecdotal evidence to go on, but they reasoned that a sore throat was often the first symptom of an Omicron infection, so why not check there for the virus?

In response, some scientists and the FDA began posting warnings on social media against throat swabbing, noting a lack of evidence to support the value of tickling the tonsils when performing a rapid antigen test.

How It’s Going

Although virtually all rapid antigen test manufacturers still recommend only nasal swabs, some public health authorities outside the US suggest that swabbing the throat and nose enhances the tests’ accuracy:

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