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Article

SARS-CoV-2 Detection Limits in Swab and Gargle Samples by Comparing Antigen and RT-qPCR Testing

by
Parastoo Kheiroddin
1,*,
Natascha Borchers
1,
Ezgi Cibali
2,
Thea Würfel
1,
Sarah Nowosadtko
1,
Michael Kabesch
1,3,† and
Andreas Ambrosch
2,†
1
Department of Pediatric Pneumology and Allergy, University Children’s Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University of Regensburg, 93049 Regensburg, Germany
2
Institute of Laboratory Medicine, Microbiology and Hygiene, Hospital of the Order of St. John, 93049 Regensburg, Germany
3
Science and Innovation Campus Regensburg (WECARE) at the Hospital St. Hedwig of the Order of St. John, 93049 Regensburg, Germany
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
COVID 2022, 2(6), 752-758; https://doi.org/10.3390/covid2060056
Submission received: 29 April 2022 / Revised: 24 May 2022 / Accepted: 2 June 2022 / Published: 8 June 2022
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Abstract

Background: Antigen tests for SARS-CoV-2 testing are rapid and inexpensive but usually have lower sensitivity than RT-qPCR and are only validated for nasopharyngeal/throat swabs; the latter are considered the gold standard in terms of material collection but are not tolerated by patients with frequent sampling. The present study, therefore, investigates the extent to which SARS-CoV-2 antigen testing is comparable to RT-qPCR from an easily obtained gargle solution compared to nasopharyngeal swabs. Methods: The performance of a high-quality POC fluorescence immune antigen test in single nasal swab samples and gargle samples compared to RT-qPCR was investigated (total n = 620 samples (gargle samples = 309, and nasal swabs = 311)). Findings: In our setting, the detection of SARS-CoV2 with an antigen test was reliable up to a Ct value of 30 for single nasal swab samples and was reduced to Ct:20 for single gargle samples. The overall antigen-test sensitivity is 83.92% (swab samples) and 75.72% (gargle samples). Interpretation: Antigen tests showed reliable results up to a detection limit of Ct: 30 with only nasal swab samples but not gargle samples. If the use of gargle samples is preferred due to their advantages, such as painless testing, easy handling, and the lack of a need to involve trained personnel for sample taking, reliable results can only be achieved with RT-qPCR.
Keywords: COVID-19; SARS-CoV-2; Germany; pool gargle; RT-qPCR; antigen test COVID-19; SARS-CoV-2; Germany; pool gargle; RT-qPCR; antigen test

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MDPI and ACS Style

Kheiroddin, P.; Borchers, N.; Cibali, E.; Würfel, T.; Nowosadtko, S.; Kabesch, M.; Ambrosch, A. SARS-CoV-2 Detection Limits in Swab and Gargle Samples by Comparing Antigen and RT-qPCR Testing. COVID 2022, 2, 752-758. https://doi.org/10.3390/covid2060056

AMA Style

Kheiroddin P, Borchers N, Cibali E, Würfel T, Nowosadtko S, Kabesch M, Ambrosch A. SARS-CoV-2 Detection Limits in Swab and Gargle Samples by Comparing Antigen and RT-qPCR Testing. COVID. 2022; 2(6):752-758. https://doi.org/10.3390/covid2060056

Chicago/Turabian Style

Kheiroddin, Parastoo, Natascha Borchers, Ezgi Cibali, Thea Würfel, Sarah Nowosadtko, Michael Kabesch, and Andreas Ambrosch. 2022. "SARS-CoV-2 Detection Limits in Swab and Gargle Samples by Comparing Antigen and RT-qPCR Testing" COVID 2, no. 6: 752-758. https://doi.org/10.3390/covid2060056

APA Style

Kheiroddin, P., Borchers, N., Cibali, E., Würfel, T., Nowosadtko, S., Kabesch, M., & Ambrosch, A. (2022). SARS-CoV-2 Detection Limits in Swab and Gargle Samples by Comparing Antigen and RT-qPCR Testing. COVID, 2(6), 752-758. https://doi.org/10.3390/covid2060056

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