An unusual collateral damage of COVID-19 pandemic

Medas, Renato; Coelho, Rosa; Macedo, Guilherme

doi:10.1016/j.gie.2020.06.017

Cited by 10 publications

(21 citation statements)

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“…In the aforementioned Treviso Hospital study, there were 3 instances of epistaxis requiring nasal packing, 2 broken swabs that lodged into the nasal cavity, prompting intervention by otolaryngologists, and 1 case of a septal abscess following nasopharyngeal swabbing [ 19 ]. In a review of the literature regarding other major complications of nasopharyngeal swabs, there were at least 7 other instances in which the nasopharyngeal swab shaft broke within the nasal cavity of the patient, all of which required endoscopy for retrieval [ [21] , [22] , [23] , [24] , [25] ]. Three of these instances involved the shaft fragment inserting inferior to the inferior nasal turbinate, while two instances involved a fragment eventually being found in the gastric cavity [ [21] , [22] , [23] , 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…In a review of the literature regarding other major complications of nasopharyngeal swabs, there were at least 7 other instances in which the nasopharyngeal swab shaft broke within the nasal cavity of the patient, all of which required endoscopy for retrieval [ [21] , [22] , [23] , [24] , [25] ]. Three of these instances involved the shaft fragment inserting inferior to the inferior nasal turbinate, while two instances involved a fragment eventually being found in the gastric cavity [ [21] , [22] , [23] , 26 ]. In a study on 96 volunteers with both commercial swabs and 3D-printed swabs, the most common complications of commercial swab sampling included headache (5.2%), rhinorrhea (5.2%), and epistaxis (8.3%); however, one participant eventually had to be hospitalized for recurrent episodic bleeding after a commercial swab test [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Role of the otolaryngologist in nasopharyngeal swab training: A case report and review of the literature

Liu

Roychowdhury

Ito

2021

Otolaryngology Case Reports

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Nasopharyngeal swabs are commonly done in the medical field for a multitude of reasons, and they recently have been an essential component of widespread testing to control the spread of COVID-19. Although rare, improper technique when performing nasopharyngeal swabs has the potential to lead to injury or misleading test results. We present a case of uncontrolled epistaxis requiring hospitalization following a routine nasopharyngeal swab in a healthy patient. Both the complexity and variability of the anatomy of the nasopharynx can contribute to poor swabbing technique. Otolaryngologists should be encouraged to educate and support other healthcare workers to improve the yield and reduce the risk of harm due to nasopharyngeal swabs. Increased comfort levels with performing nasopharyngeal swabs will also improve the sensitivity of screening tests for common respiratory viruses such as influenza, Epstein-Barr virus (EBV), or bacteria such as Staphylococcus aureus .

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Role of the otolaryngologist in nasopharyngeal swab training: A case report and review of the literature

Liu

Roychowdhury

Ito

2021

Otolaryngology Case Reports

View full text Add to dashboard Cite

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“…The literature search strategy yielded 199 citations, of which 11 articles were eligible for review (figure 2). [4][5][6][7][8][9][10][11][12][13][14]…”

Section: Resultsmentioning

confidence: 99%

Complications of Nasal SARS-CoV-2 Testing: A Review

Clark

Pang

Naclerio

et al. 2021

Journal of Investigative Medicine

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Transnasal swab testing for the detection of SARS-CoV-2 is well established. The Centers for Disease Control and Prevention advocates swabbing either of the anterior nares, middle turbinate, or nasopharynx for specimen collection depending on available local resources. The purpose of this review is to investigate complications related to transnasal SARS-CoV-2 testing with specific attention to specimen collection site and swab approach. The literature demonstrates that while nasopharyngeal swabbing is associated with an increased risk of complications, it should remain the gold-standard test due to greater diagnostic accuracy relative to anterior nasal and middle turbinate swabs.

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“…In the era of COVID-19, large numbers of patients are tested with nasopharyngeal swabs at drive-through locations remote to the hospital setting. Swab fracture with retained foreign body is unusual but has been reported in recent months as a possible complication [4,5]. The types of nasopharyngeal swabs used to collect the specimens for COVID-19 testing may vary; however, FDA-authorized instructions for several of the widely used tests recommend specimen collection using swabs with aluminum or plastic shafts [6].…”

Section: Discussionmentioning

confidence: 99%

Fractured aluminum nasopharyngeal swab during drive-through testing for COVID-19: radiographic detection of a retained foreign body

et al. 2020

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The ongoing coronavirus disease 2019 (COVID-19) pandemic has increased the need for safe and efficient testing as a key containment strategy. Drive-through testing with nasopharyngeal swab has been implemented in many places in the USA as it allows for expeditious testing of large numbers of patients, limits healthcare workers' risk of exposure, and minimizes the use of personal protective equipment. We present a case where the aluminum shaft of the nasopharyngeal swab fractured during specimen collection at a drive-through testing facility and was suspected to have remained in the asymptomatic patient. Initial evaluation with a series of radiographs covering the skull base, neck, chest, and abdomen did not reveal the swab. On further clinical evaluation, the swab was found endoscopically, lodged between the left inferior turbinate and nasal floor, and was removed by an otorhinolaryngologist. Using a phantom model, we aimed to delineate an imaging technique to better visualize the aluminum shaft of the nasopharyngeal swab on radiographs to help in identification. A technique using lower tube voltage (kVp) with tight collimation centered at the nasal bones area produced the best visualization of the aluminum shaft of the swab. Recognition that aluminum foreign bodies may be difficult to visualize radiographically and optimization of radiograph acquisition technique may help guide clinical management in unusual cases. Further evaluation with computed tomography or endoscopy should be considered in suspected cases where radiographs are negative.

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An unusual collateral damage of COVID-19 pandemic

Cited by 10 publications

References 0 publications

Role of the otolaryngologist in nasopharyngeal swab training: A case report and review of the literature

Role of the otolaryngologist in nasopharyngeal swab training: A case report and review of the literature

Complications of Nasal SARS-CoV-2 Testing: A Review

Fractured aluminum nasopharyngeal swab during drive-through testing for COVID-19: radiographic detection of a retained foreign body

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