Discordant <scp>SARS‐CoV</scp>‐2 Detection in the Nasopharynx Versus Trachea for Patients With Tracheostomies

Smith, Joshua D.; Correll, Jason A.; Stein, Julie K.; Kupfer, Robbi A.; Hogikyan, Norman D.; Morrison, Robert; Stein, Andrew P.

doi:10.1002/lary.29617

Cited by 3 publications

(1 citation statement)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The test results from nasopharyngeal swabs did not detect the virus, whereas those from tracheal secretions were able to detect the virus. [14][15][16][17] The patients with a tracheostomy because of their stoma had a closer proximity to the alveolus containing high viral content, resulting in an increased risk of aerosolization. [18][19][20][21] Therefore, the current recommendation for utilizing nasopharyngeal swabs for tracheostomized patients may not be ideal.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of SAR-CoV-2 detection using RT-PCR based testing from a nasopharyngeal swab versus indwelling tracheostomy in patients with a tracheostomy

Jiraboonsri,

Wright

2024

F1000Res

View full text Add to dashboard Cite

Background Nasopharyngeal swab RT-PCR is the standard procedure for COVID-19 testing. In patients with tracheostomy with an altered airway that bypasses the nasopharynx, the yield of samples from different sites is unknown. This information will be essential for formulating a sample collection method for COVID-19 RT-PCR testing in patients undergoing tracheostomy. Methods This was a cross-sectional study. Nasopharyngeal swabs and tracheal secretion (via closed-circuit secretion suction) samples were collected from 100 patients with a non-plugging tracheostomy tube at Thammasat University Hospital, Pathum Thani, Thailand. The participants were aged between 1-96 years old for screening purposes during the pandemic. The detection results and cycle threshold (Ct) values from each site were analyzed using McNemar’s test with a 95% confidence interval. Results Four participants had positive results. One patient tested positive only for the nasopharyngeal swab, whereas the other tested positive only for the tracheal secretion sample. No statistically significant difference was found between the discordant and concordant groups (P = 1). Conclusions We found two discordant results among the four positive cases in the 100 patients. One patient tested positive only from the nasopharyngeal swab, whereas the other tested positive only from the tracheal sample. The percentage of agreement was 98, and the kappa coefficient value was 65.64% (p <0.001). According to these results, one sample from the nasopharynx or tracheal tube should be sufficient to determine the infection status of low-risk patients. For highly suspicious cases, multisite sampling should be performed. This study showed discordance in COVID-19 RT-PCR screening results using samples from nasopharyngeal swabs and tracheal secretions in tracheotomized patients. A multiple-site sample is suggested for highly suspicious patients with tracheostomy.

show abstract

Section: Introductionmentioning

confidence: 99%

A comparative study of SAR-CoV-2 detection using RT-PCR based testing from a nasopharyngeal swab versus indwelling tracheostomy in patients with a tracheostomy

Jiraboonsri,

Wright

2024

F1000Res

View full text Add to dashboard Cite

show abstract

Usage of Heat and Moisture Exchange Devices, Virtual Visits, Masking, and Vaccinations Among People With a Laryngectomy During COVID-19

Searl

Genoa

Fritz

et al. 2023

Am J Speech Lang Pathol

View full text Add to dashboard Cite

Purpose: This study described the COVID-19 risk mitigation actions of people with a total laryngectomy (TL) during the pandemic. Method: An online survey was completed by 215 people with a TL who lived in the United States. The survey was open from December 1, 2021, to January 15, 2022. Results: There was a significant increase in frequency of heat and moisture exchange (HME) device use during the pandemic compared with pre–COVID-19. Frequency of HME use was significantly greater for those who were vaccinated and those who had at least one clinical visit with their speech-language pathologist (SLP). The use of virtual visits increased from 9% pre–COVID-19 to 37% during the pandemic. Seventy percent of respondents were “satisfied” or “very satisfied” with virtual visits and 51% judged them “as good as in-person.” Eighty percent were vaccinated for COVID-19 and 75% received a booster. One third reported that they did not wear mask over the face or over the tracheostoma. Twenty percent had tested positive for COVID-19 with 70% of these people requiring hospitalization. Conclusions: HME use and virtual SLP visits increased during the pandemic and the vaccination rate was high among this group of respondents. Overall, there were still large percentages of people with a TL who were not using an HME, not vaccinated, and did not wear a mask. SLPs should consider reaching out directly to their TL caseload, particularly those not yet seen during the pandemic, to support uptake of COVID-19 mitigation activities specific to people with a TL as the pandemic persists.

show abstract

SARS-CoV-2 infection increases airway bleeding risk in patients after tracheostomies

Tang,

Lin,

et al. 2024

Virol J

View full text Add to dashboard Cite

Background Airway bleeding events are a rare incident in SARS-CoV-2-infected patients after tracheostomies. We aimed to explore the correlation between airway bleeding and SARS-CoV-2 infection and evaluate the consistency of SARS-CoV-2 RNA test results in the upper and lower airway samples from patients after tracheostomies. Methods Forty-four patients after temporary or permanent tracheostomy were divided into a positive group (29 patients) and a negative group (15 patients) based on the SARS-CoV-2 RNA test results of their oropharyngeal swabs. The oropharyngeal and tracheal swabs of the positive group were re-collected for SARS-CoV-2 RNA detection. Demographic and clinical characteristics and airway bleeding events were recorded for all enrolled patients. Results Airway bleeding was reported in eleven patients of the positive group (11/29), with seven displaying bloody sputum or hemoptysis, and four featuring massive sputum crust formation in the trachea that resulted in dyspnea, and only one patient in the negative group (1/15), with a significant difference in the airway bleeding rate (37.9% vs. 6.7%, p < 0.05). The SARS-CoV-2 RNA test results showed a statistical difference in cycle threshold (Ct) values between oropharyngeal swabs and tracheal swabs (p < 0.05). Conclusions After tracheostomies, patients are more susceptible to airway bleeding if they are infected with SARS-CoV-2. The findings signify that in addition to droplet transmission through tracheostoma, SARS-CoV-2 may infect the oropharynx by airborne and close contact transmission, and that given the higher viral load and longer infection time in the trachea, tracheal swabs are more reliable for SARS-CoV-2 detection in these patients.

show abstract

Discordant SARS‐CoV‐2 Detection in the Nasopharynx Versus Trachea for Patients With Tracheostomies

Cited by 3 publications

References 27 publications

A comparative study of SAR-CoV-2 detection using RT-PCR based testing from a nasopharyngeal swab versus indwelling tracheostomy in patients with a tracheostomy

A comparative study of SAR-CoV-2 detection using RT-PCR based testing from a nasopharyngeal swab versus indwelling tracheostomy in patients with a tracheostomy

Usage of Heat and Moisture Exchange Devices, Virtual Visits, Masking, and Vaccinations Among People With a Laryngectomy During COVID-19

SARS-CoV-2 infection increases airway bleeding risk in patients after tracheostomies

Contact Info

Product

Resources

About