Test, test, test - a complication of testing for coronavirus disease 2019 with nasal swabs

J Laryngol Otol. 2020 Jul;134(7):646-649. doi: 10.1017/S0022215120001425. Epub 2020 Jul 28.

Abstract

Background: Coronavirus disease 2019, a highly transmissible respiratory infection, has created a public health crisis of global magnitude. The mainstay of diagnostic testing for coronavirus disease 2019 is molecular polymerase chain reaction testing of a respiratory specimen, obtained with a viral swab. As the incidence of new cases of coronavirus disease 2019 increases exponentially, the use of viral swabs to collect nasopharyngeal specimens is anticipated to increase drastically.

Case report: This paper draws attention to a complication of viral swab testing in the nasopharynx and describes the premature engagement of a viral swab breakpoint, resulting in impaction in the nasal cavity.

Conclusion: This case highlights a possible design flaw of the viral swab when used to collect nasopharyngeal specimens, which then requires an aerosol-generating procedure in a high-risk patient to be performed. The paper outlines a safe technique of nasal foreign body removal in a suspected coronavirus disease 2019 patient and suggests alternative testing materials.

Keywords: Coronavirus; Foreign Bodies; Nose.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Betacoronavirus
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques*
  • Coronavirus Infections / diagnosis*
  • Foreign Bodies / etiology*
  • Humans
  • Male
  • Nasal Cavity*
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • SARS-CoV-2
  • Specimen Handling / adverse effects*
  • Specimen Handling / instrumentation