Massive Rhinorrhea as a Complication of COVID-19 Nasopharyngeal Swab

The nasopharyngeal swab for COVID-19 testing is generally considered safe;however, it is primarily performed by staff that may not completely understand the anatomy of the nasal cavity and nasopharynx. We report the treatment of a 48-year-old man who developed unilateral left rhinorrhea after a nasopharyngeal swab sample. It is aimed to draw attention to this complication that can be prevented with the appropriate technique during nasopharyngeal swab sampling.

The sampling efficiencies of commercial nasopharyngeal swabs

Upper respiratory tract samples are the most commonly used samples for coronavirus disease 2019(COVID-19)diagnosis.The samples collected from the nasopharynx are preferred for viral nucleic acids detection.Commercial nasopharyngeal swabs(NPSs)are the major factor that influences the sampling quality.We here evaluated the acceptability and efficiency of NPSs from five manufacturers by examining the concentration of glyceraldehyde-3-phosphate dehydrogenase gene(GAPDH)retrieved from the swabs using the RT-PCR method.Significant different concentrations of GAPDH were detected,ranged from 4.36×10^(8) copies/mL to 6.98×10^(10) copies/mL among the five swabs(P<0.05).The designation of the swab head,with or without tip expansion,had limited influence on the collection efficiency.The discrepancy among the NPSs emphasized the improvement of the swab head material.

Absence of human papillomavirus in nasopharyngeal swabs from infants in a population at high risk of human papillomavirus infection

Maternal urogenital human papillomavirus(HPV)infection may place neonates at risk of HPV acquisition and subsequently lower respiratory infections as HPV can influence development of immunity.The respiratory HPV prevalence is not known in remote-dwelling Aboriginal infants,who are at high risk of respiratory infection and where the population prevalence of urogenital HPV in women is high.These data are necessary to inform HPV vaccination regimens.A retrospective analysis using PCR specific for HPV was performed on 64 stored nasopharyngeal swabs from remote-dwelling Aboriginal infants<6 months of age,with and without hospitalised pneumonia.HPV DNA was not detected in any specimen.Despite the negative result,we cannot exclude a role for HPV in respiratory infections affecting infants in this population;however,our data do not support HPV as an important contributor to acute respiratory infection in remote-dwelling Aboriginal children.

Safety management of nasopharyngeal specimen collection from suspected cases of coronavirus disease 2019

This article introduces safety management strategies of nasopharyngeal specimen collection from suspected cases of coronavirus disease 2019 in a tertiary designated hospital.The key points include establishing a special sampling room,strict sterilization of the entire environment,training of professional nurses,enhancement of personal protection,standardization of methods and processes for swab collection,and a timely and safety sample submission.More than 11,000 nasopharyngeal specimens were collected by eight nurses,with an average of 1,375 specimen swab collections each nurse,and no one was infected.

Evaluation of Rapid Detection of Nasopharyngeal Colonization with MRSA by Real-Time PCR

Objective To investigate the clinical application of Real-Time PCR for rapid detection of methicillin-resistant Staphylococcus aureus(MRSA) directly from nasopharyngeal swab specimens.Methods We collected the nasal and throat swab specimens from patients or medical staffs in 3 intensive care units,blood laminar flow ward and respiratory ward in Beijing Hospital,Ministry of Health from December 2010to April 2011.Each sample was tested by RT-PCR and conventional culture-based method for the presence of MRSA.Results The total number of the specimens was 206.Compared with the conventional culture-based method,we demonstrated the diagnostic values for Real-Time PCR were 96.4%sensitivity,96.6%specificity,81.8%positive predictive rate,and 99.4%negative predictive rate.And the limit of detection was 10~2CFU/ml.Conclusions This Real-Time PCR is a simple,rapid,sensitive and specific method.With the high negative predictive value,it can be used for the exclusion of MRSA colonization or infection.However,the application of its low positive predictive value should be further evaluated.

Efficacy of SARS-CoV-2 detection from used surgical masks compared with standard detection method

The real‐time reverse transcription‐polymerase chain reaction(RT‐PCR)test is the gold standard for severe acute respiratory syndrome coronavirus 2(SARS‐CoV‐2)detection.Proper specimen collection and obtaining a sufficient specimen are the most essential steps for laboratory diagnosis.The nasopharyngeal(NP)swab is recommended as the reference collection method.However,NP swab collection is invasive and uncomfortable for patients and poses some risk to healthcare workers.This study aimed to compare the efficacy of SARS‐CoV‐2 RNA detection from surgical masks with the NP swab method using RT‐PCR testing.Of 269 patients,RT‐PCR RNA from NP swabs was detected among 82 patients(30.5%)and was undetected among 187 patients(69.5%).All patients were tested for SARS‐CoV‐2 RNA from surgical masks.SARS‐CoV‐2 RNA was detected in 25/82(30.5%)surgical mask filters,while undetected among 57(69.5%).For the surgical mask with an average use time of 7.05 h,the sensitivity was 30.5%,the specificity was 100.0%,with positive predictive value of 100.0%and negative predictive value of 76.2%.Therefore,surgical masks could be an alternative non‐invasive specimen source for SARS‐CoV‐2 RT‐PCR testing.The results of our study suggest that the test could be employed after wearing surgical masks for at least 8‐12 h,with increased sensitivity when used for more than 12 h.

Virology features of a family cluster of SARS-CoV-2 infections in Shanghai,China

The global spread of SARS-CoV-2 is currently continuing,and the World Health Organization has announced the risk assessment of the viruses as high.In this study,we analyzed virology features of SARS-CoV-2 causing a family cluster outbreak.Among the six family members,five have been laboratory-confirmed infection of SARS-CoV-2 viruses.A total of five SARS-CoV-2 viruses have been isolated from the nasopharyngeal swabs.The complete genome of the viruses exhibited 100%nucleotide identity with each other.Only two nucleotide differences have been observed between genomes of the isolated viruses and the HCoV/Wuhan/IVDC-HB-01/2019 strain.Therefore,SARS-CoV-2 has been confirmed as the causation of the family cluster infections.