Nasal discharge: A unique enhanced alternative for the detection of respiratory pathogens in adults.

Upper respiratory tract infections are a significant cause of social- and disease burden worldwide. Currently, invasive and uncomfortable molecular detection methods are used for respiratory pathogen detection. We aimed to assess the ability and bearability of a rhinorrhea swab (RS) to detect respiratory pathogens in comparison to the combined nasopharyngeal and oropharyngeal swab (NP/OP). This study was performed at a Public Health Service severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) testing facility between November and December 2022 in the Netherlands. Adults aged 16 years and older, being subjected to a standard of care NP/OP swab with nasal discharge, were included and received an additional RS. Respiratory pathogen detection was evaluated using SARS-CoV-2 polymerase chain reaction (PCR) and multiplex ligation-dependent probe amplification (MLPA) PCR. Bearability was evaluated using visual analog scale (VAS) scores and a questionnaire. A total of 100 adults with a mean age ± SD of 46 ± 16 years were included. The NP/OP swab detected 104 pathogens, the RS 83 pathogens (p < 0.001), and in total 108 respiratory pathogens were identified in 89 adults (89%). The ability to detect respiratory pathogens compared between the RS and the combined NP/OP swab revealed a sensitivity of 82% (95% CI 73%-89%) and specificity of 100% (95% CI 72%-100%). RS were significantly more bearable than the combined NP/OP swab (p value < 0.001). Therefore, nasal discharge found in adults can be used as an adequate reliable medium for respiratory pathogen detection using SARS-CoV-2 PCR and MLPA PCR.

[The Dutch covid-19 testing policy urgently needs revision]. / Coronatestbeleid voor doelgroepen kan op de schop.

A self-test suffices for the diagnosis SARS-CoV-2 infection in the Netherlands since 11 April 2022. Yet, selected groups such as health care workers can still divert to the Public Health Services (PHS) SARS-CoV-2 testing facilities for a nucleic acid amplification test. A survey among 2257 subjects visiting PHS Kennemerland testing sites demonstrates that the majority of participants does however not belong to one of the selected groups. Most subjects visit the PHS to confirm the result of their home test. The infrastructure and personnel needed to maintain the PHS testing sites come at high costs, which are in striking contrast to the government objectives and the low number of current visitors. The Dutch covid-19 testing policy therefore urgently needs revision.