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Volume 5, Issue 12

Impact of swab removal in the detection of SARS-CoV-2 weakly-positive specimens Open Access

Graphical Abstract

Graphical Abstract

Early removal of swabs can accelerate laboratory work and enhance quality by decreasing contamination and errors in downstream procedures. This article aims to compare the traditional testing workflow in a diagnostic laboratory (red), with manual swab removal and aliquoting vs a swab-out laboratory workflow (blue).

Abstract

Removing the swab after collection can speed up diagnosis and improve the quality of laboratory procedures. This study investigates the impact of swab removal on SARS-CoV-2 detection in clinical specimens with a focus on high Cycle threshold (Ct) samples (Cts≥32). The method assessed pairs of SARS-CoV-2 samples mimicking combined throat and nose swabs and tested them on two real-time-PCR platforms; the Applied Biosystems 7500 and the Abbott Alinity. Swab removal did not significantly affect detection rates of SARS-CoV-2 samples with Ct values<32, regardless of the PCR platform. However, reduced reproducibility was seen at the endpoint limit of detection of the platforms, which meant that fewer samples with Ct values≥32 were detected in the swab removal group.

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  • Accepted:
  • Published Online:
Keyword(s): cycle threshold (Ct) , SARS-CoV-2 detection , swabbing and viral load
© 2023 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
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/content/journal/acmi/10.1099/acmi.0.000718.v3
2023-12-12
2026-01-13

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References

  1. Public Health England Evaluations, validations and verifications of diagnostic tests. In UK Standards for Microbiology Investigations vol Q1 2017 pp 1–45
     [Google Scholar]
  2. Cevik M, Tate M, Lloyd O, Maraolo AE, Schafers J et al. SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis. Lancet Microbe 2021; 2:e13–e22 [View Article] [PubMed]
     [Google Scholar]
  3. Puhach O, Meyer B, Eckerle I. SARS-CoV-2 viral load and shedding kinetics. Nat Rev Microbiol 2023; 21:147–161 [View Article] [PubMed]
     [Google Scholar]
  4. Ehret R, Breuer S, Dhein J, Reinhardt B, Obermeier M. Clinical evaluation of the automated abbott realtime SARS-CoV-2, alinity m SARS-CoV-2, and alinity m Resp-4-Plex assays. J Virol Methods 2022; 299:114338 [View Article] [PubMed]
     [Google Scholar]
  5. Greene DN, Matthys T, Lockwood CM. Swab-free transport as an optimized preanalytical workflow for SARS-CoV-2 amplification. J Appl Lab Med 2021; 6:606–613 [View Article] [PubMed]
     [Google Scholar]
  6. Stevenson LG, deFilippi CR. Swab-free transport as an optimized preanalytical workflow for SARS-CoV-2 molecular testing. J Appl Lab Med 2021; 6:580–583 [View Article] [PubMed]
     [Google Scholar]
  7. Davies E, Farooq HZ, Brown B, Tilston P, McEwan A et al. An overview of SARS-CoV-2 molecular diagnostics in Europe. Clin Lab Med 2022; 42:161–191 [View Article] [PubMed]
     [Google Scholar]
  8. Mosscrop L, Watber P, Elliot P, Cooke G, Barclay W et al. Evaluation of the impact of pre-analytical conditions on sample stability for the detection of SARS-CoV-2 RNA. J Virol Methods 2022; 309:114607 [View Article] [PubMed]
     [Google Scholar]
  9. van Kampen JJA, van de Vijver DAMC, Fraaij PLA, Haagmans BL, Lamers MM et al. Duration and key determinants of infectious virus shedding in hospitalized patients with coronavirus disease-2019 (COVID-19). Nat Commun 2021; 12:267 [View Article] [PubMed]
     [Google Scholar]
  10. He X, Lau EHY, Wu P, Deng X, Wang J et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med 2020; 26:1491–1493 [View Article] [PubMed]
     [Google Scholar]
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Impact of swab removal in the detection of SARS-CoV-2 weakly-positive specimens
Access Microbiology 5, 000718.v3 (2023); https://doi.org/10.1099/acmi.0.000718.v3
/content/journal/acmi/10.1099/acmi.0.000718.v3
/content/journal/acmi/10.1099/acmi.0.000718.v3
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