Is oro/nasopharyngeal swab for SARS-CoV-2 detection a safe procedure? Complications observed among a case series of 4876 consecutive swabs

Fabbris, Cristoforo; Cestaro, Walter; Menegaldo, Anna; Spinato, Giacomo; Frezza, Daniele; Vijendren, Ananth; Borsetto, Daniele; Boscolo‐Rizzo, Paolo

doi:10.1016/j.amjoto.2020.102758

Cited by 46 publications

(97 citation statements)

References 4 publications

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“…The resultant syndrome has been called coronavirus disease-19 and has an incubation period ranging from 2 to 14 days with a variety of potentially exhibited symptoms 5 . This can include asymptomatic patients as well as those with mild to moderate cases of influenza-like illnesses, without the need for hospitalisation [6][7][8] . In this paper, we present a case-control series focusing on mild to moderate symptoms to formulate a general overview of COVID-19.…”

Section: Introductionmentioning

confidence: 99%

The importance of early detection of ENT symptoms in mild-to-moderate COVID-19

Spinato

Costantini

Fabbris

et al. 2021

Acta Otorhinolaryngol Ital

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Objectives. Patients with coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may present with a wide range of symptoms. In this paper, a detailed characterisation of mild-to-moderate ear, nose nd throat (ENT) symptoms is presented with the aim of recognising the disease early to help reduce further spread and progression. Methods. A total of 230 cases testing positive for SARS-CoV-2 and 134 negative controls were recruited for a case-control analysis. Symptoms were analysed using the Acute Respiratory Tract Infections Questionnaire, while other symptoms were investigated by ad hoc questions.Results. Among the study samples (n = 364), 149 were males and 215 were females with age ranging from 20 to 89 years (mean 52.3). Four main groups of symptoms were obtained: influenza-like symptoms, ENT-symptoms, breathing issues and asthenia-related symptoms, representing 72%, 69%, 64% and 53% of overall referred clinical manifestations, respectively. ENT symptoms, breathing issues and influenza-like symptoms were associated with positivity to SARS-CoV-2, whereas asthenia-related symptoms did not show a significant association with SARS-CoV-2 infection after controlling for other symptoms, comorbidities and demographic characteristics. Conclusions. ENT symptoms are equally represented with influenza-like ones as presenting symptoms of COVID-19. Patients with ENT symptoms should be investigated for early identification and prevention of SARS-CoV-2 spread.

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Section: Introductionmentioning

confidence: 99%

The importance of early detection of ENT symptoms in mild-to-moderate COVID-19

Spinato

Costantini

Fabbris

et al. 2021

Acta Otorhinolaryngol Ital

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“…Unfortunately, these possibilities have become reality in a few instances. A retrospective study performed at Treviso Hospital involving over 4000 patients found that one patient with a nasal septal deviation experienced uncontrollable bleeding after a swab, necessitating correction via surgical cauterization [ 19 ]. In another case report, a patient with a preexisting skull base defect developed a CSF leak following a routine swab that required surgical intervention [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Even in patients without these conditions, serious injuries resulting from nasopharyngeal swabs can occur. 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] ].…”

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

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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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“…Die Literatur zeigt konsistent eine höhere Sensitivität des Nasen-Rachen-Abstrichs, sodass dieser Methodik der Vorzug gegeben werden sollte [ 9 , 10 ]. Neben Komplikationen wie Nasenbluten und lokaler Abszessbildung gibt es in der Literatur bisher nur wenige Berichte schwerwiegenderer Folgen einer solchen Prozedur [ 11 ].…”

Section: Diskussionunclassified

Iatrogene Liquorfistel als Folge eines SARS-CoV-2-Nasopharyngealabstrichs

Perneczky

Wuchty

Sellner

2021

psychopraxis. neuropraxis

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In Österreich wurden seit Beginn der COVID-19(„coronavirus disease 2019“)-Pandemie über 16 Mio. Abstriche durchgeführt, wobei hier bevorzugt Nasen-Rachen-Abstriche zum Einsatz kommen. Neben Blutungen und lokalen Abszessen gibt es wenige Daten hinsichtlich möglicher schwerwiegenderer Komplikationen. Anhand von 4 Kasuistiken wird eine iatrogene Liquorfistel als mögliche Folge eines Nasen-Rachen-Abstriches aufgezeigt. Bei entsprechenden Symptomen sollte an diese seltene, jedoch potenziell lebensgefährliche Komplikation gedacht werden.

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Is oro/nasopharyngeal swab for SARS-CoV-2 detection a safe procedure? Complications observed among a case series of 4876 consecutive swabs

Cited by 46 publications

References 4 publications

The importance of early detection of ENT symptoms in mild-to-moderate COVID-19

The importance of early detection of ENT symptoms in mild-to-moderate COVID-19

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

Iatrogene Liquorfistel als Folge eines SARS-CoV-2-Nasopharyngealabstrichs

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