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Nonserologic test for COVID-19: How to manage?
Head Neck. 2020 Jul; 42(7):1552-1554.HN

Abstract

BACKGROUND

Diagnosis of Severe Acute Respiratory Coranavirus-2 (SARS-CoV-2) infection is currently based on real-time PCR (RT-PCR) performed on either nasopharyngeal (NPS) or oropharyngeal (OPS) swabs; saliva specimen collection can be used, too. Diagnostic accuracy of these procedures is suboptimal, and some procedural mistakes may account for it.

METHODS AND RESULTS

The video shows how to properly collect secretions from the upper airways for nonserologic diagnosis of COVID-19 by nasopharyngeal swab (NPS), oropharyngeal swab (OPS), and deep saliva collection after throat-cleaning maneuver, all performed under videoendoscopic view by a trained ENT examiner.

CONCLUSIONS

We recommend to perform NPS after elevation of the tip of the nose in order to reduce the risk of contamination from the nasal vestible, and to let it flow over the floor of the nasal cavity in parallel to the hard palate in order to reach the nasopharynx. Then the tip of the swab should be left in place for few seconds, and then rotated in order to achieve the largest absorption of nasopharyngeal secretions. Regards OPS, gentle anterior tongue depression should be used to avoid swab contamination from the oral cavity during collection of secretions from the posterior pharyngeal wall. These procedural tricks would enhance diagnostic reliability.

Authors+Show Affiliations

Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy.Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Department of Biomedical Surgical Dental Science, University of Milan, Milan, Italy.

Pub Type(s)

Journal Article
Video-Audio Media

Language

eng

PubMed ID

32441380

Citation

Torretta, Sara, et al. "Nonserologic Test for COVID-19: How to Manage?" Head & Neck, vol. 42, no. 7, 2020, pp. 1552-1554.
Torretta S, Zuccotti G, Cristofaro V, et al. Nonserologic test for COVID-19: How to manage? Head Neck. 2020;42(7):1552-1554.
Torretta, S., Zuccotti, G., Cristofaro, V., Ettori, J., Solimeno, L., Battilocchi, L., D'Onghia, A., Pignataro, L., & Capaccio, P. (2020). Nonserologic test for COVID-19: How to manage? Head & Neck, 42(7), 1552-1554. https://doi.org/10.1002/hed.26270
Torretta S, et al. Nonserologic Test for COVID-19: How to Manage. Head Neck. 2020;42(7):1552-1554. PubMed PMID: 32441380.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonserologic test for COVID-19: How to manage? AU - Torretta,Sara, AU - Zuccotti,Gianvincenzo, AU - Cristofaro,Valentina, AU - Ettori,Jacopo, AU - Solimeno,Lorenzo, AU - Battilocchi,Ludovica, AU - D'Onghia,Alessandra, AU - Pignataro,Lorenzo, AU - Capaccio,Pasquale, Y1 - 2020/05/22/ PY - 2020/05/05/received PY - 2020/05/05/accepted PY - 2020/5/23/pubmed PY - 2020/7/21/medline PY - 2020/5/23/entrez SP - 1552 EP - 1554 JF - Head & neck JO - Head Neck VL - 42 IS - 7 N2 - BACKGROUND: Diagnosis of Severe Acute Respiratory Coranavirus-2 (SARS-CoV-2) infection is currently based on real-time PCR (RT-PCR) performed on either nasopharyngeal (NPS) or oropharyngeal (OPS) swabs; saliva specimen collection can be used, too. Diagnostic accuracy of these procedures is suboptimal, and some procedural mistakes may account for it. METHODS AND RESULTS: The video shows how to properly collect secretions from the upper airways for nonserologic diagnosis of COVID-19 by nasopharyngeal swab (NPS), oropharyngeal swab (OPS), and deep saliva collection after throat-cleaning maneuver, all performed under videoendoscopic view by a trained ENT examiner. CONCLUSIONS: We recommend to perform NPS after elevation of the tip of the nose in order to reduce the risk of contamination from the nasal vestible, and to let it flow over the floor of the nasal cavity in parallel to the hard palate in order to reach the nasopharynx. Then the tip of the swab should be left in place for few seconds, and then rotated in order to achieve the largest absorption of nasopharyngeal secretions. Regards OPS, gentle anterior tongue depression should be used to avoid swab contamination from the oral cavity during collection of secretions from the posterior pharyngeal wall. These procedural tricks would enhance diagnostic reliability. SN - 1097-0347 UR - https://www.unboundmedicine.com/medline/citation/32441380/Nonserologic_test_for_COVID_19:_How_to_manage L2 - https://doi.org/10.1002/hed.26270 DB - PRIME DP - Unbound Medicine ER -