A Severe Acute Respiratory Syndrome Coronavirus 2 detection method based on nasal and nasopharyngeal lavage fluid: A pilot feasibility study

Laryngoscope Investigative Otolaryngology

article

Daniele Frezza MD¹  Cristoforo Fabbris MD¹  Leonardo Franz MD¹  Elisa Vian MD³  Roberto Rigoli MD³  Rosalba De Siati MD¹  Enzo Emanuelli MD¹  Luigi Bertinato MD⁴  Paolo Boscolo-Rizzo MD²  Giacomo Spinato MD¹ 

[1] Unit of Otorhinolaryngology;Department of Neurosciences, Section of Otolaryngology, University of Padova;Department of Clinical Pathology;National Institute of Health;Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste;Department of Surgery, Oncology and Gastroenterology, Section of Oncology and Immunology, University of Padova

关键词: COVID-19;    diagnosis;    nasal irrigation;    preventive care;    saline solution;    swab;   

DOI  :  10.1002/lio2.625

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

Objective Nose and nasopharyngeal swab is the preferred and worldwide-accepted method to detect the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) within the nose and nasopharynx. This method may be linked with possible difficulties, such as patient's discomfort or complications. This article shows a pilot study of SARS-CoV-2 detection with nasal and nasopharyngeal lavage fluids (level of evidence: 3). Methods Nasal lavage fluid was collected from patients who were submitted to SARS-CoV-2 screening test, due to a preceding positive rapid antigen test. A control group was enrolled among health care professionals whose nasopharyngeal swab tested negative. Nasal lavages were performed using isotonic saline solution injected through a nasal fossa. Both lavage fluid and traditional nasopharyngeal swab were analyzed by real-time (RT) PCR and antigenic test. Results A total of 49 positive subjects were enrolled in the study. Results of the analysis on lavages and nasopharyngeal swabs were concordant for 48 cases, regardless of the antigenic and molecular test performed. RT-PCR resulted weakly positive at swab in one case and negative at lavage fluid. Among the control group (44 subjects), nasopharyngeal swab and lavage fluid analyses returned a negative result. Sensitivity of the molecular test based on nasal lavage fluid, compared to traditional nasal swab, was 97.7%, specificity was 100%, and accuracy was 98.9%, with high agreement (Cohen's κ, 0.978). Conclusion Nasal and nasopharyngeal lavages resulted to be highly reliable and well tolerated. A larger series is needed to confirm these results. This approach may potentially represent a valid alternative to the traditional swab method in selected cases. Level of Evidence 3.

【 授权许可】

CC BY|CC BY-NC-ND