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Covid-19: oropharyngeal swabs and pooling

The HCSP recommends to use nasopharyngeal swabs in priority for the RT-PCR diagnosis of SARS-CoV-2 infection. Sampling should be performed by operators trained in this technique. Posterior oropharyngeal swabs are an alternative.

The evaluation of molecular tests based on saliva samples should be pursued; sputum is not a sufficiently standardised sample type to be recommended for the diagnosis of Covid-19

The HCSP encourages rigorous evaluation of any new technology that would allow to accelerate the diagnosis with acceptable clinical sensitivity.

Based on the updated review of the literature, the HCSP maintains its previous recommendations of not using sample pooling. Pooling samples in a context of increased virus circulation would indeed be likely to increase response delays for positive samples and to rise the risk of false negative results due to the possible lower sensitivity of this strategy.

A multidisciplinary study implying for instance virologists, clinicians, epidemiologists, primary care practitioners and public health physicians is recommended in order to determine the acceptable loss of sensitivity with regard to the sampling methods (self-sampling in particular) and/or techniques that would meet public health requirements in terms of volume of screening and the shortening of response time.

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