tetano
Editor, Senior Moderator
Head Neck
. 2020 Jun 12.
doi: 10.1002/hed.26317. Online ahead of print.
False-positive Reverse Transcriptase Polymerase Chain Reaction Screening for SARS-CoV-2 in the Setting of Urgent Head and Neck Surgery and Otolaryngologic Emergencies During the Pandemic: Clinical Implications
Andrew P Katz[SUP] 1 [/SUP], Francisco J Civantos[SUP] 1 [/SUP], Zoukaa Sargi[SUP] 1 [/SUP], Jason M Leibowitz[SUP] 1 [/SUP], Elizabeth A Nicolli[SUP] 1 [/SUP], Donald Weed, Alexander E Moskovitz[SUP] 1 [/SUP], Alyssa M Civantos[SUP] 2 [/SUP], David M Andrews[SUP] 3 [/SUP], Octavio Martinez[SUP] 3 [/SUP], Giovana R Thomas[SUP] 1 [/SUP]
Affiliations
Abstract
Background: No reports describe falsepositive reverse transcriptase polymerase chain reaction (RT-PCR) for novel coronavirus in preoperative screening.
Methods: Preoperative patients had one or two nasopharyngeal swabs, depending on low or high risk of viral transmission. Positive tests were repeated.
Results: Forty-three of 52 patients required two or more preoperative tests. Four (9.3%) had discrepant results (positive/negative). One of these left the coronavirus disease (COVID) unit against medical advice despite an orbital abscess, with unknown true disease status. The remaining 3 of 42 (7.1%) had negative repeat RT-PCR. Although ultimately considered falsepositives, one was sent to a COVID unit postoperatively and two had urgent surgery delayed. Assuming negative repeat RT-PCR, clear chest imaging, and lack of subsequent symptoms represent the "gold standard," RT-PCR specificity was 0.97.
Conclusions: If false positives are suspected, we recommend computed tomography (CT) of the chest and repeat RT-PCR. Validated serum immunoglobulin testing may ultimately prove useful.
Keywords: COVID-19; RT-PCR; head and neck surgery; pandemic; preoperative testing.
. 2020 Jun 12.
doi: 10.1002/hed.26317. Online ahead of print.
False-positive Reverse Transcriptase Polymerase Chain Reaction Screening for SARS-CoV-2 in the Setting of Urgent Head and Neck Surgery and Otolaryngologic Emergencies During the Pandemic: Clinical Implications
Andrew P Katz[SUP] 1 [/SUP], Francisco J Civantos[SUP] 1 [/SUP], Zoukaa Sargi[SUP] 1 [/SUP], Jason M Leibowitz[SUP] 1 [/SUP], Elizabeth A Nicolli[SUP] 1 [/SUP], Donald Weed, Alexander E Moskovitz[SUP] 1 [/SUP], Alyssa M Civantos[SUP] 2 [/SUP], David M Andrews[SUP] 3 [/SUP], Octavio Martinez[SUP] 3 [/SUP], Giovana R Thomas[SUP] 1 [/SUP]
Affiliations
- PMID: 32530131
- DOI: 10.1002/hed.26317
Abstract
Background: No reports describe falsepositive reverse transcriptase polymerase chain reaction (RT-PCR) for novel coronavirus in preoperative screening.
Methods: Preoperative patients had one or two nasopharyngeal swabs, depending on low or high risk of viral transmission. Positive tests were repeated.
Results: Forty-three of 52 patients required two or more preoperative tests. Four (9.3%) had discrepant results (positive/negative). One of these left the coronavirus disease (COVID) unit against medical advice despite an orbital abscess, with unknown true disease status. The remaining 3 of 42 (7.1%) had negative repeat RT-PCR. Although ultimately considered falsepositives, one was sent to a COVID unit postoperatively and two had urgent surgery delayed. Assuming negative repeat RT-PCR, clear chest imaging, and lack of subsequent symptoms represent the "gold standard," RT-PCR specificity was 0.97.
Conclusions: If false positives are suspected, we recommend computed tomography (CT) of the chest and repeat RT-PCR. Validated serum immunoglobulin testing may ultimately prove useful.
Keywords: COVID-19; RT-PCR; head and neck surgery; pandemic; preoperative testing.