Complications of nasal and pharyngeal swabs: a relevant challenge of the COVID-19 pandemic?

Föh, Bandik; Borsche, Max; Balck, Alexander; Taube, Stefan; Rupp, Jan; Klein, Christine; Katalinic, Alexander

doi:10.1183/13993003.04004-2020

Cited by 56 publications

(59 citation statements)

References 8 publications

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“…Wrong trajectory of the applicator can also be hazardous to the nasal structures. Complication rates are low, and they are minor and self-limiting in most cases, but severe adverse events have also occurred, including liquorrhea [4,5,7,9,10,15]. Asthma and respiratory allergy prevalence is still increasing [16].…”

Section: Discussionmentioning

confidence: 99%

“…The nasal anatomy and breakpoint mechanism of the swab can result in a foreign body being retained [4][5][6]8,11]. Broken parts moving forward can either stick at the pharyngeal level or be aspirated or swallowed into the stomach, but only ingestions have been reported [3][4][5]. In one case, a nursing staff broke a wooden applicator during NPS, and the patient ingested the foreign body.…”

Section: Discussionmentioning

confidence: 99%

“…Nasopharyngeal (NPS) and oropharyngeal swabs (OPS) are the mainstays of sampling for either laboratory tests or point-of-care devices. Despite the significant number of tests performed, only few adverse events of swabbing have been reported [2][3][4][5][6][7][8][9][10][11]. Insertion of such applicators through natural orifices confers the possibility of foreign body retention with various consequences.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Safety Precautions for Self-Performed Severe Acute Respiratory Syndrome Coronavirus 2 Tests: A Case of a Swallowed Swab

Molnár

Zsigmond

Helfferich

2021

Cureus

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Oropharyngeal and nasopharyngeal specimens collected by swabbing are the pillars of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostics. Commercially available rapid antigen tests and self-sampling polymerase chain reaction services have made specimen collection available anytime and anywhere in nonmedical settings. In this study, we report the case of a 45-year-old man who accidentally ingested a swab during self-performed SARS-CoV-2 rapid antigen testing. Imaging studies revealed an elongated foreign body in the stomach. Urgent gastroscopy confirmed the presence of the swabbing applicator in the gastric lumen, which was retrieved using a loop without any complications. Millions of SARS-CoV-2 tests are performed daily, of which an increasing proportion are performed by laypeople. Foreign bodies account for a particular set of complications, which can be avoided by cautious sampling and using the correct technique. Radiopaque labeling of instruments would be useful. Otherwise, rare serious events can occur that may require immediate medical interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Safety Precautions for Self-Performed Severe Acute Respiratory Syndrome Coronavirus 2 Tests: A Case of a Swallowed Swab

Molnár

Zsigmond

Helfferich

2021

Cureus

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“…Complications due to nasal swabbing for SARS-CoV-2 is relatively rare with WHO reporting a prevalence of adverse events (AEs) of 0.026% 3 . The WHO has admitted that this figure is underreported, and even with correction the incidence of complications due to swabbing is quite low.…”

Section: Discussionmentioning

confidence: 99%

“…The WHO has admitted that this figure is underreported, and even with correction the incidence of complications due to swabbing is quite low. There have been only three published cases describing pharyngeal swab complications up-to-date, out of these there was only one reported case of epistaxis and this did not require surgical intervention 3 . Since there was an obvious error in swab technique and/or patient preparation let us consider the recommended technique for taking a swab when detecting or screening for SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

Epistaxis following post nasal swabbing – the new COVID related emergency?

Karunathilaka¹,

Drahaman²,

Lakshan

et al. 2020

Ceylon J Otolaryngology

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Case overview A patient who got admitted at term for an elective caesarean section underwent an 'on admission' routine nasopharyngeal swabbing for SARS-CoV-2. She developed resistant epistaxis one day after the procedure and was found to have a mucosal injury over the sphenopalatine artery entry point on the left side. She had to undergo an emergency caesarean section followed by endonasal sphenopalatine artery ligation. The epistaxis was successfully dealt with and the mother and baby were discharged 48 hours after surgery. Conclusions Proper training in nasopharyngeal swab technique is required. Departments need to consider having biodegradable nasal packing material for such instances. In such injuries early endonasal sphenopalatine artery ligation (ESPAL) should be considered as traditional methods available to us were not successful.

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Evaluation of a SARS‐CoV‐2 antigen‐detecting rapid diagnostic test as a self‐test: Diagnostic performance and usability

Cassuto¹,

Gravier

Colin

et al. 2021

Journal of Medical Virology

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To control the spread of the coronavirus disease 2019 (COVID‐19) epidemics, it is necessary to have easy‐to‐use, reliable diagnostic tests available. The nasopharyngeal sampling method being often uncomfortable, nasal sampling could prove to be a viable alternative to the reference sampling method. We performed a multicentre, prospective validation study of the COVID‐VIRO® test, using a nasal swab sampling method, in a point‐of‐care setting. In addition, we performed a multicentre, prospective, and usability study to validate the use of the rapid antigen nasal diagnostic test by laypersons. In March 2021, 239 asymptomatic and symptomatic patients were included in the validation study. Compared with reverse‐transcription polymerase chain reaction on nasopharyngeal samples, the sensitivity and specificity of the COVID‐VIRO® Antigen test combined with a nasal sampling method were evaluated as 96.88% and 100%, respectively. A total of 101 individuals were included in the usability study. Among these, 99% of the participants rated the instructions material as good, 98% of the subjects executed the test procedure well, and 98% of the participants were able to correctly interpret the test results. This study validates the relevance of COVID‐VIRO® as a diagnostic tool from nasal specimens as well as its usability in the general population. COVID‐VIRO® diagnostic performances and ease of use make it suitable for widespread utilization.

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Complications of nasal and pharyngeal swabs: a relevant challenge of the COVID-19 pandemic?

Cited by 56 publications

References 8 publications

Safety Precautions for Self-Performed Severe Acute Respiratory Syndrome Coronavirus 2 Tests: A Case of a Swallowed Swab

Safety Precautions for Self-Performed Severe Acute Respiratory Syndrome Coronavirus 2 Tests: A Case of a Swallowed Swab

Epistaxis following post nasal swabbing – the new COVID related emergency?

Evaluation of a SARS‐CoV‐2 antigen‐detecting rapid diagnostic test as a self‐test: Diagnostic performance and usability

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