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Comparative Study
. 2020 Oct 27;15(10):e0241100.
doi: 10.1371/journal.pone.0241100. eCollection 2020.

A comparison of health care worker-collected foam and polyester nasal swabs in convalescent COVID-19 patients

Brian Hart  1 , Yuan-Po Tu  2 , Rachel Jennings  3 , Prateek Verma  1 , Leah R Padgett  4 , Douglas Rains  4 , Deneen Vojta  1 , Ethan M Berke  1
Affiliations
Comparative Study

A comparison of health care worker-collected foam and polyester nasal swabs in convalescent COVID-19 patients

Brian Hart et al. PLoS One. .

Abstract

Both polyester and foam nasal swabs were collected from convalescent COVID-19 patients at a single visit and stored in viral transport media (VTM), saline or dry. Sensitivity of each swab material and media combination were estimated, three by three tables were constructed to measure polyester and foam concordance, and cycle threshold (Ct) values were compared. 126 visits had polyester and foam swabs stored in viral transport media (VTM), 51 had swabs stored in saline, and 63 had a foam swab in VTM and a polyester swab stored in a dry tube. Polyester and foam swabs had an estimated sensitivity of 87.3% and 94.5% respectively in VTM, 87.5% and 93.8% respectively in saline, and 75.0% and 90.6% respectively for dry polyester and foam VTM. Polyester and foam Ct values were correlated, but polyester showed decreased performance for cases with a viral load near the detection threshold and higher Ct values on average.

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Conflict of interest statement

Brian Hart, Rachel Jennings, Prateek Verma, Deneen Vojta, and Ethan Berke were employees of UnitedHealth Group during the design and analysis of the study and initial drafting of the manuscript. Yuan-Po Tu is an employee of The Everett Clinic, which is a subsidiary of UnitedHealth Group. Leah R. Padgett and Douglas Rains are employees of Quantigen Biosciences and have performed contract services for Thermo Fisher Scientific. The specific roles of these authors are articulated in the ‘author contributions’ section. The competing interests implied by the authors’ employer/employee relationships do not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Ct correlation plots.
Plots showing the cycle threshold (Ct) values for each of the three RNA targets and three transport media. The black line represents the best fitting linear regression, the dashed blue line represents a perfect one-to-one relationship.
Fig 2
Fig 2. Ct difference boxplots.
Plots showing the difference in cycle threshold (Ct) of the polyester and foam swabs collected at the same visits. Positive values represent higher Ct values in the polyester swab. The dashed red line represents equivalent Ct values. The percentage of samples for which the foam swab has a lower Ct value is shown below each sub-plot.
Fig 3
Fig 3. Paired Ct plots.
Paired Ct plots showing the polyester and foam Ct values for each transport media and target gene combination considered. Swabs collected at the same visit are connected by a black line.
See this image and copyright information in PMC

References

    1. Coronavirus Disease 2019 (COVID-19) in the US. Centers for Disease Control and Prevention, accessed September 15, 2020. https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html
    1. Seelye KQ, Jacobs A, Becker J, Arango T. Doctors and Governors Vie for Masks in Cloak- and Dagger Deals. New York Times. April 20, 2020.
    1. Artenstein AW. In Pursuit of PPE. New England Journal of Medicine. 2020. April 17:e46 10.1056/NEJMc2010025 - DOI - PMC - PubMed
    1. A joint statement by the Association of State and Territorial Health Officials, Association of Public Health Laboratories, and Council of State and Territorial Epidemiologists. COVID-19 Testing Needs to Be Limited to Priority Groups Until Sufficient Testing Supplies and Personal Protective Equipment is Available Nationwide. Association of State and Territorial Health Officials. March 20, 2020.
    1. Tu YP, Jennings R, Hart B, Cangelosi GA, Wood RC, Wehber K, et al. Swabs Collected by Patients or Health Care Workers for SARS-CoV-2 Testing. New England Journal of Medicine. 2020. June 3. - PMC - PubMed

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