Sampling site matters when testing for COVID-19 after total laryngectomy: a case report

Schmid, Johannes; Prattes, Juergen; Kaufmann-Bühler, Ann-Katrin; Riedl, Jakob M.

doi:10.1007/s00508-021-01826-x

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…Among them, 7 were excluded due to lack of clinical cases, or since they were clearly not related to the object of research [ 7 , 11 – 16 ]. Eventually, 3 articles dealing about 4 patients were analyzed [ 8 – 10 ]. Patients underwent only NP in 2 cases, while both NP and TR were performed in the other 2 cases.…”

Section: Resultsmentioning

confidence: 99%

“…Correct procedure of collecting a sample for SARS-CoV-2 testing in this type of patients is not clearly specified in the international guidelines. The matter of whether a laryngectomized subject should be tested via a nasopharyngeal sample or via a tracheal one has been discussed only in a few papers [ 7 , 9 , 10 ]. Although totally laryngectomized patients have no significant airflow through the nasopharynx, they can still develop sinonasal diseases; therefore, testing should be performed both in the upper (nasopharynx) and lower (tracheal) areas [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…17 (who did not have SP) had a surprising negative TR and a positive NP. As stated by Schmid et al [ 10 ], the primary site of infection could have been the lower respiratory tract, potentially followed by later infection of the upper respiratory one via autoinoculation or systemic infection. Therefore, these cases strengthen the recommendation of testing the patients with both nasopharyngeal and tracheal sample.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the execution of diagnostic tests must take into consideration the abovementioned anatomical alterations of the upper airways, since the nasopharynx and oral cavity are separated from the lower airways. To date, different methods have been suggested, and generally both nasal and tracheal testing have been recommended, since discrepancies have been encountered between samples collected from the two areas [ 7 – 10 ]. By the way, only case reports have been presented; thus, no robust conclusions have been obtained [ 8 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, different methods have been suggested, and generally both nasal and tracheal testing have been recommended, since discrepancies have been encountered between samples collected from the two areas [ 7 – 10 ]. By the way, only case reports have been presented; thus, no robust conclusions have been obtained [ 8 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Discrepancies of SARS-CoV-2 testing results among patients with total laryngectomy

Fabbris

Boaria²,

Boscolo‐Rizzo

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose Prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is obtained with nasopharyngeal swabs. By the way, there is no consensus regarding sampling in totally laryngectomized subjects (who thus breathe directly by the tracheostomy and, theoretically, may be infected in the trachea). The aim of this study is to evaluate possible differences between swab results in the trachea and in the nasopharynx of this category of patients. Methods A retrospective chart review was performed in April 2021 among patients who previously had been operated on for total laryngectomy and who underwent swabs for SARS-CoV-2 research in 3 health-care centers in Northern–Eastern Italy. Data regarding the site of swabbing (trachea or nasopharynx) were analyzed. A comprehensive review of the literature regarding the same topic was then performed. Results A total of 25 totally laryngectomized subjects underwent swabs. Among them, 5 tested positive in the trachea (1) and in the nasopharynx (4). According to the literature review, 4 more subjects tested positive in the trachea (1) and in the nasopharynx (3). Data were overall divergent and no statistically significant correlations emerged between results of the tests performed in the two sites. Conclusion Due to these discrepancies, both tracheal and nasopharyngeal swabs are recommended in these kinds of patients, to obtain a reliable test and to avoid false negatives. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-07203-8.

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