scholarly journals An Unusual Retained Choanal Foreign Body: A Possible Complication of COVID-19 Testing With Nasopharyngeal Swab

2021 ◽  
pp. 014556132199393
Author(s):  
Michele Gaffuri ◽  
Pasquale Capaccio ◽  
Sara Torretta ◽  
Marco Daga ◽  
Gian Vincenzo Zuccotti ◽  
...  
Keyword(s):  
Foreign Body ◽  
Nasopharyngeal Swab ◽  
Chain Reaction ◽  
Superior Turbinate ◽  
Specimen Collection ◽  
Body Retention ◽  
Nasal Anatomy ◽  
Polymerase Chain ◽  
Upper Level ◽  
The One

Testing for coronavirus disease 2019 is critical in controlling the pandemic all over the world. Diagnosis of severe acute respiratory syndrome coronavirus-2 infection is based on real-time polymerase chain reaction performed on nasopharyngeal swab. If not adequately performed, the viral specimen collection can be painful and lead to complications. We present a complication occurred during a nasopharyngeal swab collection performed in a noncooperative patient where the plastic shaft of the swab fractured during the procedure, resulting in swab tip retention deep into the nasal cavity. The foreign body was found endoscopically, stuck between the nasal septum and the superior turbinate tail at the upper level of the left choana and removed under general anesthesia in a negative pressure operating room with the health care personnel wearing personal protective equipment. Unpleasant complications like the one described can happen when the swab is collected without the necessary knowledge of nasal anatomy or conducted inappropriately, especially in noncooperative patients. Moreover, the design of currently used viral swabs may expose to accidental rupture, with risk of foreign body retention in the nasal cavities. In such cases, diagnosis and treatment are endoscopy-guided procedures performed in an adequate setting to minimize the risk of spreading of the pandemic.

scholarly journals Outcome of COVID-19 in Solid Organ Malignancies: Experience From a Tertiary Cancer Center in Eastern India

2021 ◽  
pp. 1374-1379
Author(s):  
Somnath Roy ◽  
Joydeep Ghosh ◽  
Sandip Ganguly ◽  
Debapriya Mondal ◽  
Deepak Dabkara ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Reverse Transcriptase ◽  
Median Duration ◽  
Cancer Center ◽  
Nasopharyngeal Swab ◽  
Solid Organ ◽  
Chain Reaction ◽  
Unique Challenge ◽  
Risk Of Death ◽  
Polymerase Chain

PURPOSE The COVID-19 pandemic has imposed a unique challenge to oncology patients. Outcome data on COVID-19 in patients with cancer from the Indian subcontinent are scarce in the literature. We aimed to evaluate the outcome of patients with COVID-19 on active systemic anticancer therapy. MATERIALS AND METHODS This is a retrospective study of patients with solid organ malignancies undergoing systemic therapy with a diagnosis of COVID-19 between March 2020 and February 2021. COVID-19 was diagnosed if a reverse transcriptase polymerase chain reaction assay from oropharyngeal or nasopharyngeal swab was positive for severe acute respiratory syndrome coronavirus 2. The objectives were to evaluate the outcome of COVID-19 and factors predicting the outcome. RESULTS A total of 145 patients were included with a median age of 58 years (range, 20-81 years). Treatment was curative in 60 (42%) patients. Of all symptomatic cases (n = 88, 61%), 50 had mild, 27 had moderate and 19 had severe COVID-19–related symptoms as per WHO criteria. Fifty (34%) patients required hospitalization with a median duration of hospital stay of 12 days (range, 4-25 days); five patients required intensive care unit admission. The rest were treated with home isolation and did not require further hospitalization. Twenty-two (15%) patients died, and the risk of death was significantly associated with severity of symptoms (odds ratio, 91.3; 95% CI, 9.1 to 919.5, P = .0001) but not with any other clinical factors. Drug holiday was given to 63 (44%) patients with a median duration of 25 days (range, 7-88 days). The median duration to reverse transcriptase polymerase chain reaction–negative was 16 days (range, 7-62 days). CONCLUSION COVD-19–related death rate was 15% among patients with solid organ malignancies. The severity of the symptoms was related to mortality. The majority of patients with mild symptoms were treated at home isolation.

scholarly journals Viral Load Dynamics in Sputum and Nasopharyngeal Swab in Patients with COVID-19

2020 ◽  
Vol 99 (11) ◽  
pp. 1239-1244 ◽  
Author(s):  
R. Liu ◽  
S. Yi ◽  
J. Zhang ◽  
Z. Lv ◽  
C. Zhu ◽  
...  
Keyword(s):  
Viral Load ◽  
Quantitative Polymerase Chain Reaction ◽  
Nasopharyngeal Swab ◽  
Chain Reaction ◽  
Global Pandemic ◽  
Observational Cohort ◽  
Polymerase Chain ◽  
Underlying Diseases ◽  
Temporal Profiles ◽  
Substantial Morbidity

Coronavirus disease 2019 (COVID-19) has caused a global pandemic associated with substantial morbidity and mortality. Nasopharyngeal swabs and sputum samples are generally collected for serial viral load screening of respiratory contagions, but temporal profiles of these samples are not completely clear in patients with COVID-19. We performed an observational cohort study at Renmin Hospital of Wuhan University, which involved 31 patients with confirmed COVID-19 with or without underlying diseases. We obtained samples from each patient, and serial viral load was measured by real-time quantitative polymerase chain reaction. We found that the viral load in the sputum was inclined to be higher than samples obtained from the nasopharyngeal swab at disease presentation. Moreover, the viral load in the sputum decreased more slowly over time than in the nasopharyngeal group as the disease progressed. Interestingly, even when samples in the nasopharyngeal swab turned negative, it was commonly observed that patients with underlying diseases, especially hypertension and diabetes, remained positive for COVID-19 and required a longer period for the sputum samples to turn negative. These combined findings emphasize the importance of tracking sputum samples even in patients with negative tests from nasopharyngeal swabs, especially for those with underlying conditions. In conclusion, this work reinforces the importance of sputum samples for SARS-CoV-2 detection to minimize transmission of COVID-19 within the community.

scholarly journals COVID-19 Autopsies, Oklahoma, USA

2020 ◽  
Vol 153 (6) ◽  
pp. 725-733 ◽  
Author(s):  
Lisa M Barton ◽  
Eric J Duval ◽  
Edana Stroberg ◽  
Subha Ghosh ◽  
Sanjay Mukhopadhyay
Keyword(s):  
Diffuse Alveolar Damage ◽  
Nasopharyngeal Swab ◽  
Protective Equipment ◽  
Chain Reaction ◽  
Polymerase Chain Reaction Testing ◽  
Standard Procedures ◽  
History Of ◽  
Polymerase Chain ◽  
Viral Inclusions ◽  
Postmortem Examinations

Abstract Objectives To report the methods and findings of two complete autopsies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive individuals who died in Oklahoma (United States) in March 2020. Methods Complete postmortem examinations were performed according to standard procedures in a negative-pressure autopsy suite/isolation room using personal protective equipment, including N95 masks, eye protection, and gowns. The diagnosis of coronavirus disease 2019 (COVID-19) was confirmed by real-time reverse transcriptase polymerase chain reaction testing on postmortem swabs. Results A 77-year-old obese man with a history of hypertension, splenectomy, and 6 days of fever and chills died while being transported for medical care. He tested positive for SARS-CoV-2 on postmortem nasopharyngeal and lung parenchymal swabs. Autopsy revealed diffuse alveolar damage and chronic inflammation and edema in the bronchial mucosa. A 42-year-old obese man with a history of myotonic dystrophy developed abdominal pain followed by fever, shortness of breath, and cough. Postmortem nasopharyngeal swab was positive for SARS-CoV-2; lung parenchymal swabs were negative. Autopsy showed acute bronchopneumonia with evidence of aspiration. Neither autopsy revealed viral inclusions, mucus plugging in airways, eosinophils, or myocarditis. Conclusions SARS-CoV-2 testing can be performed at autopsy. Autopsy findings such as diffuse alveolar damage and airway inflammation reflect true virus-related pathology; other findings represent superimposed or unrelated processes.

scholarly journals Detection of SARS-CoV-2 by real time Reverse Transcriptase-Polymerase Chain Reaction assay in pleural effusion

2021 ◽  
pp. 201
Author(s):  
Keyword(s):  
Polymerase Chain Reaction ◽  
Pleural Effusion ◽  
Reverse Transcriptase ◽  
Pleural Fluid ◽  
Interstitial Pneumonia ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Pleural Involvement

SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2) is a novel coronavirus identified for the first time in Wuhan (China) in 2019, responsible of the current pandemic infection known as Coronavirus-19 disease (COVID-19). Wide range of clinical presentation of COVD -19 has been observed, from asymptomatic carriers to ARDS. The common signs and symptoms of SARS-CoV-2 infection include fever, fatigue, dry cough, and dyspnoea; the severity of the disease is due to the impairment of the respiratory function. The radiological findings include a large variety of lesions; bilateral interstitial pneumonia is the most concerning presentation of COVID-19. Pleural involvement has been described in a minority of cases: pleural thickening had been observed in 32% of cases whereas pleural effusion is uncommon being described in only 5%. Furthermore, pleural involvement has been significantly associated with a worse prognosis. Coronavirus 2 (SARS-CoV-2), beyond the nasopharyngeal swab, has been detected in other samples; up to now, data about RT-PCR specific results in the pleural fluid of patients suffering from coronavirus disease 2019 5 (COVID-19) are very limited. The current gold standard for diagnosis is nucleic acid detection by real time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) in nasopharyngeal swab. In this report, a case of a positive RT-PCR for Sars-Cov-2 in the pleura fluid and in the naso- pharyngeal swab of a patient affected by bilateral interstitial pneumonia and severe respiratory failure is described. As the presence of SARS-Cov-2 in the pleural fluid seems to be associated to a poor prognosis, physicians should carry out the specific RT-PCR assay both in the nasopharyngeal swab and in the pleural sample also when the fluid amount is very scarce and not recognizable in the chest X ray. Furthermore, the analysis of multiple samples allows to increase the test reliability.

scholarly journals Performance of qualitative and quantitative antigen tests for SARS-CoV-2 in early symptomatic patients using saliva

2020 ◽  
Author(s):  
Isao Yokota ◽  
Takayo Sakurazawa ◽  
Junichi Sugita ◽  
Sumio Iwasaki ◽  
Keiko Yasuda ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Gold Standard ◽  
Rapid Detection ◽  
Disease Outbreaks ◽  
Nasopharyngeal Swab ◽  
Chain Reaction ◽  
Qualitative And Quantitative ◽  
Polymerase Chain ◽  
Antigen Tests ◽  
Chemiluminescent Enzyme Immunoassay

AbstractBackgroundThe rapid detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an urgent need for the prevention and containment of disease outbreaks in communities. Although the gold standard is polymerase chain reaction (PCR), antigen tests such as immunochromatographic assay (ICA) and chemiluminescent enzyme immunoassay (CLEIA) that can yield results within 30 minutes.MethodsWe evaluated performance of ICA and CLEIA using 34 frozen PCR-positive specimens (17 saliva and 17 nasopharyngeal swab) and 307 PCR-negative samples.ResultsICA detected SARS-CoV-2 in only 14 (41%) samples, with positivity of 24% in saliva and 59% in NPS. Notably, ICA detected SARS-CoV-2 in 5 (83%) of 6 samples collected within 4 days after symptom onset. CLEIA detected SARS-CoV-2 in 31 (91%) samples, with positivity of 82% in saliva and 100% in NPS. CLEIA was negative in 3 samples with low viral load by PCR.ConclusionsThese results suggest that use of ICA should be limited to earlier time after symptom onset and CLEIA is more sensitive and can be used in situations where quick results are required.

scholarly journals The Demographic Risk Factors for Brucellosis in Asia

2021 ◽  
pp. 6-13
Author(s):  
Sumi Singh
Keyword(s):  
Risk Factors ◽  
Direct Contact ◽  
Mixed Type ◽  
One Health ◽  
Asian Countries ◽  
Chain Reaction ◽  
True Prevalence ◽  
Global Trend ◽  
Polymerase Chain ◽  
The One

Brucellosis is also known as Undulant fever, Malta fever, rock fever, intermittent fever, Gibraltar fever, contagious abortion, Maltese fever, Crimean fever, or even Mediterranean fever. Clinical manifestations commonly encountered are fever and arthralgia. It has veterinary importance making it the leading cause of abortion and infertility in animals. Countries in which mixed agriculture is still the leading occupation have reported this disease in high number. The disease is common in areas where the mixed type of farming is still practiced, it is a type of farming where owners cohabit with their animals in the shed during the nighttime. The incidence of the disease is reported more in humans who have direct contact with the animal’s abortus fetus and reproductive secretions. A favorable environment is created for transmission when the healthy and infected animals are kept together free and are difficult to segregate. Diagnosis of the disease is done by isolation of the bacteria from the sample using the polymerase chain reaction (PCR) technique. The disease was claimed to be eradicated but now as the global trend of infectious diseases is constantly changing it now appears to be a re-emergent disease. The best way to prevent the spread of the infection is through the One Health approach. Although brucellosis has been widely reported in animals and humans only a few studies have addressed the true prevalence of the disease in the context of Asia which is quite a challenge. It is unable to provide the true context of the disease. The case burden is more prevalent in the developing countries where it is found to be endemic in animals as well as in humans. Thus, this paper highlights the risk factors commonly found in Asian countries that are associated with increased prevalence of infection in humans which has now been believed to be involved many generations across the globe. Countries in which mixed agriculture is still the leading occupation have reported this disease in high number. The disease is common in areas where the mixed type of farming is still practiced, it is a type of farming where owners cohabit with their animals in the shed during the nighttime. The incidence of the disease is reported more in humans who have direct contact with the animal’s abortus fetus and reproductive secretions. A favorable environment is created for transmission when the healthy and infected animals are kept together free and are difficult to segregate. Diagnosis of the disease is done by isolation of the bacteria from the sample using the polymerase chain reaction (PCR) technique. The disease was claimed to be eradicated but now as the global trend of infectious diseases is constantly changing it appears to be a re-emergent disease. The best way to prevent the spread of the infection is through the One Health approach. Although brucellosis has been widely reported in animals and humans only a few studies have addressed the true prevalence of the disease in the context of Asia which is quite a challenge. It is unable to provide the true context of the disease. The case burden is more prevalent in the developing countries where it is found to be endemic in animals as well as in humans. Thus, this paper highlights the risk factors commonly found in Asian countries that are associated with increased prevalence of infection in humans which has now been believed to be involved many generations across the globe.

scholarly journals Acute Severe Bilateral Visual Loss as Presenting Symptom of COVID-19 Infection

2021 ◽  
Vol 18 (3) ◽  
Author(s):  
Kazem Ghaemi ◽  
Tahereh Darvishpour Kakhki ◽  
Fatemeh Abbasi ◽  
Malihe Nikandish
Keyword(s):  
Visual Loss ◽  
Posterior Cerebral Artery ◽  
Cranial Nerves ◽  
Occipital Cortex ◽  
Nasopharyngeal Swab ◽  
Chain Reaction ◽  
Case Presentation ◽  
Wide Range ◽  
Brain Ct Scan ◽  
Polymerase Chain

Introduction: Coronavirus disease 2019 (COVID-19) has emerged as a pandemic and is accompanied by extraordinary morbidity and mortality. Critically ill COVID-19 patients have frequent thrombotic problems and laboratory evidence of hypercoagulability. The spectrum of presentations and complications of COVID-19 is still evolving. We describe a patient with unusual visual symptoms as the presenting signs of COVID-19. Case Presentation: In this case report, we describe a patient who presented with acute severe bilateral visual loss and headache. On neurological examination, cranial nerves were normal. There was no motor and sensorial abnormality. While the patient was in the emergency room, he was tested positive for COVID-19 via nasopharyngeal swab polymerase chain reaction (PCR) as part of COVID-19 surveillance. An unenhanced brain CT scan showed infarction in the occipital cortex bilaterally due to ischemic stroke involving the Posterior Cerebral Artery (PCA). A few hours later, oxygen saturation was 42%, and a sudden decline of consciousness was observed, progressing to coma. The neurosurgery intervention failed to change the patient's status, and he was pronounced dead in the next few hours. Conclusions: This case illuminates a wide range of COVID-19-related symptomatology and highlights the need for clinicians to be aware of different clinical appearances associated with this infection.

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