Complications of COVID-19 Nasopharyngeal Swab Test

Koskinen, Anni; Tolvi, Morag; Jauhiainen, Maria K; Kekäläinen, Eliisa; Laulajainen‐Hongisto, Anu; Lamminmäki, Satu

doi:10.1001/jamaoto.2021.0715

Cited by 47 publications

(62 citation statements)

References 6 publications

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“…Overall, nasopharyngeal swabs are considered as a safe procedure, and complications are very rare. A study on more than 600,000 patients showed a complication rate of 1.24 per 100,000 performed SARS-CoV-2 tests, with the patient needing acute treatment in an emergency department [ 19 ]. Nose bleeding is the most common complication and should be kept in mind, especially if the swab meets resistance before 8 cm.…”

Section: Discussionmentioning

confidence: 99%

Optimal Insertion Depth for Nasal Mid-Turbinate and Nasopharyngeal Swabs

et al. 2021

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Millions of people are tested for COVID-19 daily during the pandemic, and a lack of evidence to guide optimal nasal swab testing can increase the risk of false-negative test results. This study aimed to determine the optimal insertion depth for nasal mid-turbinate and nasopharyngeal swabs. The measurements were made with a flexible endoscope during the collection of clinical specimens with a nasopharyngeal swab at a public COVID-19 test center in Copenhagen, Denmark. Participants were volunteer adults undergoing a nasopharyngeal SARS-CoV-2 rapid antigen test. All 109 participants (100%) completed the endoscopic measurements; 52 (48%) women; 103 (94%) white; mean age 34.39 (SD, 13.2) years; and mean height 176.7 (SD, 9.29) cm. The mean swab length to the posterior nasopharyngeal wall was 9.40 (SD, 0.64) cm. The mean endoscopic distance to the anterior and posterior end of the inferior turbinate was 1.95 (SD, 0.61) cm and 6.39 (SD, 0.62) cm, respectively. The mean depth to nasal mid-turbinate was calculated as 4.17 (SD, 0.48) cm. The optimal depths of insertion for nasal mid-turbinate swabs are underestimated in current guidelines compared with our findings. This study provides clinical evidence to guide the performance of anatomically correct nasal and nasopharyngeal swab specimen collection for virus testing.

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Section: Discussionmentioning

confidence: 99%

Optimal Insertion Depth for Nasal Mid-Turbinate and Nasopharyngeal Swabs

et al. 2021

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“…Recent retrospectives reviews assessed the complications related to swab testing during the COVID-19 pandemic. Fabbris et al [ 2 ] found a low number of complications (0.16%), and Koskinen et al [ 10 ] reported an even lower rate (0.001%). Most were related to epistaxis (in some cases severe, requiring surgical procedures and blood transfusion) or broken swab impacted in the nasal cavity [ 2 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Fabbris et al [ 2 ] found a low number of complications (0.16%), and Koskinen et al [ 10 ] reported an even lower rate (0.001%). Most were related to epistaxis (in some cases severe, requiring surgical procedures and blood transfusion) or broken swab impacted in the nasal cavity [ 2 , 10 ]. Other complications of nasal swabs have been described, such as nasal septum abscess, cerebrospinal fluid leak, and cribriform lamina fracture [ 2 , 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Ethmoidal silent sinus syndrome after nasal swab test

et al. 2021

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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%

“…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%

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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Complications of COVID-19 Nasopharyngeal Swab Test

Cited by 47 publications

References 6 publications

Optimal Insertion Depth for Nasal Mid-Turbinate and Nasopharyngeal Swabs

Optimal Insertion Depth for Nasal Mid-Turbinate and Nasopharyngeal Swabs

Ethmoidal silent sinus syndrome after nasal swab test

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

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