{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T18:29:10Z","timestamp":1786472950008,"version":"build-2736575974"},"reference-count":11,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"crossref","award":["INF-HKU-3"],"award-info":[{"award-number":["INF-HKU-3"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Research Grants Council","award":["T11-712\/19-N"],"award-info":[{"award-number":["T11-712\/19-N"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accurate detection of respiratory viruses relies on appropriate sample collection, but whether joint nose and throat sampling is necessary for high diagnostic performance or whether nose sampling alone can provide comparable results remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We evaluated the diagnostic agreement between joint nose and throat swabs (NTS) and Rhinoswab (RhinoMed, Cremorne, Australia), a novel anterior nasal swab for RT-qPCR detection of respiratory viruses among symptomatic outpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Outpatients with febrile acute respiratory illness were enrolled at a clinic in Hong Kong and paired joint NTS and Rhinoswab samples were tested by reverse transcription polymerase chain reaction (RT-qPCR) for influenza A, influenza B, SARS-CoV-2 and human ribonuclease P (RNase P) as an internal control. Diagnostic agreement and RT-qPCR Ct values were compared between the paired samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between May 2023 and April 2024, 488 participants provided paired samples. Overall concordance between Rhinoswab and NTS was 98.0% (95% CI: 96.3% to 99.0%) for influenza A, 99.0% (95% CI: 97.6% to 99.7%)\u00a0for influenza B, and 99.0% (95% CI: 97.6% to 99.7%) for SARS-CoV-2. Cohen\u2019s kappa also indicated high agreement for all viruses: 0.95 (95% CI: 0.92 to 0.98) for influenza A, 0.94 (95% CI: 0.88 to 0.99) for influenza B, and 0.92 (95% CI: 0.85 to 0.99) for SARS-CoV-2. Ct values from Rhinoswab were moderately correlated with NTS for all three viruses and RNase P. The majority of discordant samples had Ct values of 30 and above (16\/18, 88.9%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rhinoswabs achieved high agreement with joint NTS for RT-qPCR detection of influenza and SARS-CoV-2. Given their minimal invasiveness Rhinoswabs are a viable alternative specimen type for supervised respiratory virus testing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0355869","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:31:32Z","timestamp":1786469492000},"page":"e0355869","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic agreement between Rhinoswabs and joint nose and throat swabs for the detection of influenza and SARS-CoV-2 among symptomatic ambulatory patients in Hong Kong"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6570-0582","authenticated-orcid":true,"given":"Caitriona","family":"Murphy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7293-2331","authenticated-orcid":true,"given":"Samuel M. S.","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loretta","family":"Mak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3119-1527","authenticated-orcid":true,"given":"Hau Chi","family":"So","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis K. M.","family":"Ip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malik","family":"Peiris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6297-7154","authenticated-orcid":true,"given":"Benjamin J.","family":"Cowling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"issue":"1","key":"pone.0355869.ref001","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s44263-024-00121-x","article-title":"Effectiveness and user experience of nose and throat swabbing techniques for SARS-CoV-2 detection: results from the UK COVID-19 National Testing Programme","volume":"3","author":"ME Futschik","year":"2025","journal-title":"BMC Glob Public Health"},{"key":"pone.0355869.ref002","doi-asserted-by":"crossref","first-page":"114713","DOI":"10.1016\/j.jviromet.2023.114713","article-title":"Evaluation of a novel anterior nasal swab for the detection of SARS-CoV-2","volume":"316","author":"A Crowe","year":"2023","journal-title":"J Virol Methods"},{"issue":"1","key":"pone.0355869.ref003","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1186\/s12887-023-03976-5","article-title":"A novel anterior nasal swab to detect respiratory viruses: a prospective study of diagnostic accuracy","volume":"23","author":"S Tosif","year":"2023","journal-title":"BMC Pediatr"},{"issue":"1","key":"pone.0355869.ref004","doi-asserted-by":"crossref","first-page":"116421","DOI":"10.1016\/j.diagmicrobio.2024.116421","article-title":"Diagnostic performance of multiplex lateral flow tests in ambulatory patients with acute respiratory illness","volume":"110","author":"C Murphy","year":"2024","journal-title":"Diagn Microbiol Infect Dis"},{"key":"pone.0355869.ref005","article-title":"Evaluation of a new standardized nasal sampling method for detection of SARS-CoV-2 RNA via RT-PCR","volume":"12","author":"JGM Koeleman","year":"2024","journal-title":"Microorganisms"},{"issue":"5","key":"pone.0355869.ref006","article-title":"Performance of saliva, oropharyngeal swabs, and nasal swabs for SARS-CoV-2 molecular detection: a systematic review and meta-analysis","volume":"59","author":"RA Lee","year":"2021","journal-title":"J Clin Microbiol"},{"issue":"8","key":"pone.0355869.ref007","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1080\/23744235.2021.1903550","article-title":"Diagnostic accuracy of nasopharyngeal swab, nasal swab and saliva swab samples for the detection of SARS-CoV-2 using RT-PCR","volume":"53","author":"Y Tsujimoto","year":"2021","journal-title":"Infect Dis (Lond)"},{"issue":"7","key":"pone.0355869.ref008","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2024.e28647","article-title":"Evaluation of SARS-CoV-2 quantification from oropharyngeal swabs, nasopharyngeal swabs, and naso-oropharyngeal swabs: a cross-sectional study","volume":"10","author":"F Ibrahim","year":"2024","journal-title":"Heliyon"},{"issue":"5","key":"pone.0355869.ref009","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.3390\/diagnostics12051091","article-title":"Clinical evaluation of nasopharyngeal, oropharyngeal, nasal swabs, and saliva for the detection of SARS-CoV-2 by direct RT-PCR","volume":"12","author":"SA Kiryanov","year":"2022","journal-title":"Diagnostics (Basel)"},{"issue":"5","key":"pone.0355869.ref010","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1056\/NEJMc2016321","article-title":"Swabs collected by patients or health care workers for SARS-CoV-2 testing","volume":"383","author":"Y-P Tu","year":"2020","journal-title":"N Engl J Med"},{"key":"pone.0355869.ref011","doi-asserted-by":"crossref","first-page":"104417","DOI":"10.1016\/j.jcv.2020.104417","article-title":"Self-collection: an appropriate alternative during the SARS-CoV-2 pandemic","volume":"128","author":"MC Wehrhahn","year":"2020","journal-title":"J Clin Virol"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0355869","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:31:37Z","timestamp":1786469497000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0355869"}},"subtitle":[],"editor":[{"given":"Hin Fung","family":"Tsang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,8,11]]},"references-count":11,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0355869","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,11]]}}}