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Nasal swabs are more accurate than oral swabs

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The new coronavirus results are an important reference for the diagnosis and efficacy evaluation of new coronavirus pneumonia. Nucleic acid test screening samples are mostly derived from deep cough sputum or throat swabs. The throat swabs are divided into nasopharyngeal swabs and oropharyngeal swabs. What is the difference between the two?

Nasopharyngeal swab:

Deputy Director Cai Yuexin said that the pharynx includes the nasopharynx, oropharynx, and waiting pharynx. The three have continuous mucous membranes and all belong to the upper respiratory tract area. Nasopharyngeal swabs and oropharyngeal swabs are just different sampling paths. Oral sampling is an oropharyngeal swab, and nasal sampling is a nasopharyngeal swab.

Deputy Chief Physician Liang Faya said that since the oropharyngeal swab can be operated by opening the mouth, it is relatively simple, so it is often used clinically. However, the risk of exposure to oropharyngeal swab sampling patients is very high. The sampling operator needs to face the patient. During the sampling process, the patient is prone to symptoms such as irritating dry cough and vomiting, so that the sampler is exposed to aerosol transmission with the virus. .

Expert studies have found that nasal swabs are easier to detect positive nucleic acid, the sampling time can stay in the nasopharynx for longer, and larger samples can be obtained. This is also the reason for the higher positive rate of nasopharyngeal swabs reported in the literature . In addition, if the patient’s tolerance is high, surface anesthesia and contraction of the nasal mucosa can usually be performed first, and a skilled sampler can sample the patient without anesthesia.

When nasopharyngeal sampling, the operator can stand behind the patient’s side, so the patient lowers the mask to expose only the nostrils and cover the mouth. There is no need to look directly at the patient’s mouth. There is almost no pharyngeal reflex, and the exposure risk is quite low. Each patient may have a sneeze reflex after sampling, or it can be blocked immediately with elbows and tissues.

If the collection of pharyngeal swab nucleic acid test specimens is not standardized, it may lead to “false negative” results and delay the patient’s treatment.

So, what is the key to the sampling of throat swab nucleic acid test specimens? Deputy Chief Physician Tian Peng said that whether it is sampling of nasopharyngeal swabs or oropharyngeal swabs, the depth of sampling and the contact time of the swabs with the mucous membrane are very important. Even if the nasopharyngeal swab is sampled, it may not be possible to collect the deep part of the nasopharynx. If the oropharyngeal swab is collected, the patient’s vomiting reaction is large and the sampling time is insufficient, then the sample collected may be virus-free, which is It is very likely to cause “false negatives” in the acid test. The “rejuvenation” of some patients after nucleic acid testing has a lot to do with inaccurate sampling.

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