RT-PCR Test: Nasopharyngeal Swab vs Nasal Swab vs Mid-turbinate swab

At present, the more accurate COVID-19 testing uses RT-PCR to evaluate whether there is SAR-CoV-2 RNA in the collected samples. It is almost certain that the subject is infected with the virus if there is.  In addition to the flocking oropharyngeal swab, there are three sampling swabs used in the nasal cavity, which are nasopharyngeal swab, nasal swab, and mid-turbinate swab.

Differences in the nasopharyngeal swabs, nasal swab, and middle-turbinate swab

1. Nasopharyngeal swab

FEATURES

• The nasopharyngeal test takes a specimen from the back wall of the nasopharynx.
• Some experts said that the viral load in the nasopharyngeal area is higher than anterior nasal area, and that samples from that area are more suitable for virus detection. Some experts said that the viral load in the nasopharyngeal area is higher than the anterior nasal area and that samples from that area are more suitable for virus detection.
• The shaft with breakpoint allows the user to easily place the flocking swab into the sampling tube after collecting the specimen.
• Since the nasopharynx is a sensitive part of the body, patients may feel itchy or painful when collecting samples with a np swab, and they may sneeze.
• The back wall of the nasopharyngeal (nasopharynx) is relatively close to the inside. For safety reasons, you need to be extremely careful when using nasopharyngeal swabs, which means higher requirements for the operator’s technique and slightly lower efficiency.

INDICATIONS

Viruses for respiratory diseases such as influenza, Pertussis, COVID-19, and other medical tests

HOW TO USE

1. Tilt your head to back 70° to keep the swab parallel to the upper jaw, and then slowly insert the swab into the nasal cavity until resistance is encountered.
2. Gently rotate the swab to rub the inner wall of the nasopharynx for 5-10 seconds, and then let it stand for a few seconds to allow the flocking swab to absorb the sample fully.
3. The swab is slowly taken out while rotating, and use the same swab enters the throat in the other nostril to repeat the collection action. 
4. Insert the np swab into the sample storage solution and tighten the lid after breaking off at the breakpoint.

CAUTIONS

• Hand hygiene must be maintained when using nasopharyngeal flocking swabs.
• The user is required to be trained to insert the swab in the correct direction and not to use brute force.
• The patient needs to seek immediate medical attention when he experiences nosebleeds or severe pain.
• People with facial trauma or coagulopathy should choose the anterior nasal swab test or the buccal swab test.

2. Mid-turbinate swab

FEATURES

• Sampling from the middle turbinate position is not as uncomfortable as the nasopharyngeal area.
• There are breakpoints on the flocking swab shaft, which helps to improve the speed and ease of handling samples.
• The flocking mid-turbinate swabs with blocking point prevent you from inserting the swab too deeply and causing injury.

INDICATIONS

Genetic testing, quarantine, physical examination, laboratory virus testing, etc.

HOW TO USE

1. Slowly rotate the mid-turbinate swab into the nostril until resistance is felt at the turbinate.
2. Gently rotate the swab on the turbinate several times for 3-5 seconds.
3. To improve the accuracy of the test, samples can be taken from the turbinate bone of the other nostril using the same swab.
4. After sampling, store the swab in a test tube or sample preservation solution and tighten the lid.

CAUTIONS

• Clean your hands before using the swab to avoid contaminating the mid-turbinate swab.
• If your turbinate is enlarged or your nasal canal is narrow and the swab cannot be inserted before it reaches the turbinate, you should try to get the swab from another nasal cavity, or use an anterior nasal swab, oropharyngeal swab, saliva swab, etc.
• Children’s swabs should be used when taking samples from infants and young children. They are usually shorter and have a smaller tip.

3. Anterior Nasal Swab/Nasal Swab

FEATURES

• It is not easy to cause discomfort to collect samples in the anterior nose position, and people with narrow nasal passages can use it.
• The difficulty of sampling is low and patient can easily complete the anterior nasal sampling on his own.

INDICATIONS

Influenza, covid-149, and other respiratory diseases

HOW TO USE

1. Insert the swab into the front of the nose and rotate it repeatedly. It is recommended to stay in the nasal cavity for 15 seconds to obtain enough samples.
2. You need to take the same flocking swab to the other nasal cavity for collection.

CAUTIONS

• After opening the swab, keep your hands away from the tip of the swab to avoid contamination
• The swab should be inserted into the nostril at least 1 cm and no more than 1.5 cm.
• Repeat the above steps with the same swab on the other nostril to get more samples.
• Due to the low viral load of the sample at the anterior nasal site, the test results may be false negative, so it may be necessary to retest with other methods, depending on the individual’s exposure history and symptoms.

CONCLUSION

Although nasopharyngeal swabs, nasal swabs, and mid-turbinate swabs have different sampling methods, they can all be used to collect samples and then use the PCR results to determine whether the sample owner is infected with covid-19.

If you use the swab for collection yourself, you must purchase the product from a regular medical institution. Read the instructions carefully or watch the operation video before collecting yourself, and the flocking swab cannot be reused.

If you are worried about the inaccuracy of your operating methods or the test results are not true, you should go to the hospital or a particular testing agency to perform the nasal swab PCR test. Only they can provide professional personnel to collect for you, thereby improving the test accuracy and preventing you were infected with a virus brought by others when you were collected.