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A&J Fotos/Getty ImagesSARS-CoV-2 (the virus that causes COVID-19) infects the upper respiratory system — the nose, mouth, and throat — which is why some people have tested positive for COVID-19 after swabbing their throat with an at-home rapid test.
Throat swabbing isn’t a new phenomenon — throat swabs are frequently used to diagnose other respiratory infections caused by influenza, rhinovirus, and adenoviruses.
Earlier in the pandemic, scientists discovered that people’s saliva can contain high levels of the coronavirus and that saliva testing can be just as reliable as deep nasal swabbing.
More recent research suggests that saliva swabs may be more useful with Omicron, since the variant is thought to infect the upper respiratory system more efficiently.
Though most of the rapid tests available at your local pharmacy are currently only authorized for nasal swabs, some doctors say it might be worth swabbing your throat in addition to your nose, as doing so can increase the test’s ability to detect the coronavirus.
Other doctors believe that until we have more data or guidance from the test manufacturers saying whether kits can be safely and effectively used on the throat, too, it’s best to use the tests as instructed.
A small pre-print study found that Omicron variant COVID-19 infections may be better detected by saliva swabs, since the variant infects and replicates more efficiently in the bronchus.
Delta, on the other hand, better attacks the lungs and upper airways.
“They found that the throat swab provided more of a sample, increasing sensitivity for picking up the signal for the coronavirus,” said Dr. Sri Banerjee, an epidemiologist and faculty member in Walden University’s PhD in Public Health program.
Another report from South Africa similarly found that saliva swabs conducted via a PCR test were more accurate at detecting the Omicron variant than the nasal swabs.
Where those nasal swabs caught all the Delta variant COVID infections, they missed 14 percent of the Omicron variant COVID infections — but the saliva swabs caught 100 percent of the Omicron COVID infections.
Scientists are still uncovering why some people may have more coronavirus in their nose than their mouth, and vice versa.
According to Banerjee, Omicron may be more likely to infect upper airway cells that reside in the throat.
“The differences in tissue tropism may be something unique to Omicron and behind the earlier positivity of saliva,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security and an infectious disease expert.
Adalja says saliva and oropharyngeal testing has always been an option, even with other variants.
SARS-CoV-2 infects the upper respiratory tract, which includes the mouth, nose, and throat.
Previous research has confirmed that the coronavirus infects oral tissues, which is likely why virus is detectable in saliva.
Dr. Purvi Parikh, an immunologist with Allergy & Asthma Network, suspects another reason there is is detectable virus in the throat is because virus travels to the throat from the lungs and nasal passages.
“Many viruses and bacteria drip down to your throat from your nose. Anything from your lungs coughs up to the throat area and can be sampled there, especially if you have a sore throat,” Parikh said.
Dr. Emily Volk, the president of the College of American Pathologists, recommends that people closely follow the instructions on the test kit.
For now, she doesn’t recommend people use antigen tests to swab their throats at home — at least until there is more data or updated guidance from the test manufacturers.
“It’s really hard to swab your own throat,” Volk said, adding that some people might hurt themselves or swab the wrong part of the throat.
But other doctors say it’s worth a try, as swabbing both your throat and nose can increase the test’s sensitivity. You can talk with your physician about what they recommend. Currently, the FDA and CDC are not recommending swabbing your throat.
Banerjee says if you want to swab your throat it is important to not just swab the tongue or the wall of the mouth.
“Tip the head back and collect the specimen from the surface of one or both tonsils, the tonsillar pillars or the posterior pharyngeal wall — all of which are in the very back of the throat,” Banerjee said.
Lastly, avoid food or drinks for at least 30 minutes before conducting the test. There is a chance that not doing so could lead to false positives or impact how much coronavirus is collected.
SARS-CoV-2 (the virus that causes COVID-19) infects the upper respiratory system — the nose, mouth, and throat — which is why some people have tested positive for COVID-19 after swabbing their throat with an at-home rapid test.
Though most of the rapid tests available at your local pharmacy are currently only authorized for nasal swabs, some doctors say it might be worth swabbing your throat in addition to your nose, as doing so can increase the test’s ability to detect coronavirus.