New research that will help improve sample quality and patient experience in COVID-19 testing was recently published by BC-CfE research assistants Natalie Kinloch and Aniqa Shahid. Kinloch and Shahid are also PhD students in the Faculty of Health Sciences at Simon Fraser University under the supervision of SFU Professor and BC-CfE laboratory director Dr. Zabrina Brumme. Their findings were published in the scientific journal Open Forum Infectious Diseases.
Nasopharyngeal swabs are critical to COVID-19 diagnostics, but collection techniques vary. The swabbing procedure is also notoriously uncomfortable. With the goal of improving sample collection quality and patient experience, Kinloch and Shahid teamed up with Dr. Victor Leung, Medical Director of Infection Prevention and Control at Providence Health Care, to evaluate two commonly used swab collection techniques.
Specimen collection involves inserting a long flexible swab through the nostril all the way to the back of the throat to an area called the nasopharynx. This is a depth of about seven centimetres. The procedure must be performed by a trained healthcare professional familiar with the technique and nasal anatomy. There is, however, no consensus on what to do with the swab once it reaches the nasopharynx. In particular, many guidance documents recommend that the swab be rotated in place after contacting the nasopharynx, while others indicate that this is not necessary.
The research team recruited adult volunteers to undergo a nasopharyngeal swab with or without rotation, and asked the volunteers to rate their discomfort during the swab procedure. Kinloch and Shahid also used a laboratory technique called droplet digital polymerase chain reaction (ddPCR) to assess nucleic acid recovery as a marker of swab collection quality.
Their results revealed that swab rotation did not enhance sample quality. Furthermore, responses from the participants suggested that rotation made the procedure less tolerable. The team’s first major conclusion was therefore that swabs do not need to be rotated during sample collection.
Kinloch and Shahid’s results additionally revealed that discomfort during the swab test varied widely: when participants were asked to rate their discomfort on a scale from zero to 10, their responses ranged from 1 to 10! On average, Asian participants reported higher levels of discomfort than those who self-identified as White, a finding that may be explained by differences in nasal anatomy among ethnic groups. The team’s second major conclusion was that care providers need to be sensitive to such differences in people’s experiences. The team is working with Dr. Leung to translate their findings into an improved COVID-19 diagnostic experience for people getting tested.
Of the research, Kinloch said, “As a basic scientist, I often feel quite removed from the people my work will hopefully one day help. It has been very rewarding to contribute directly to the on-going COVID-19 pandemic response and be a part of research that has implications for clinical practice.”
As for her contribution to the published study, Shahid said, “This research was indeed a result of a dynamic and collaborative team effort at SFU, BC-CfE and PHC. I am excited to be a part of the scientific community that is actively working to accelerate our current understanding of the COVID-19 pandemic.
This research, funded by Genome BC, was undertaken in partnership with Simon Fraser University and Providence Health Care. Ms. Kinloch is supported by a Vanier Canada Graduate Scholarship and Ms. Shahid by a CIHR Fredrick Banting and Charles Best Doctoral Award.