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Review
. 2022 Apr;279(4):2193-2196.
doi: 10.1007/s00405-021-07203-8. Epub 2021 Dec 2.

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

C Fabbris  1 , F Boaria  2 , P Boscolo-Rizzo  3 , E Emanuelli  4 , G Spinato  2   5
Affiliations
Review

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

C Fabbris et al. Eur Arch Otorhinolaryngol. 2022 Apr.

Abstract

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.

Keywords: COVID-19; Nasopharyngeal swab; SARS-CoV-2; Total laryngectomy; Tracheal swab.

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Conflict of interest statement

The authors have no conflict of interest, funding or financial relationships. An informed consent has been obtained for any procedure involving the patients described in this article. The manuscript has not been submitted to more than one journal for simultaneous consideration. The manuscript has not been published previously (party or in full). All of the authors have participated in the planning, writing or revising the manuscript.

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