Providing Evidence for Dogma: Risk of Epistaxis After COVID-19 Nasal-Screening Swab.

Autor: Block-Wheeler NR; Department of Head and Neck Surgery, Kaiser Permanente East Bay, Oakland, California, USA., Wei J; Division of Research, Kaiser Permanente, Oakland, California, USA., Weintraub MR; Department of Graduate Medical Education, Kaiser Permanente East Bay, Oakland, California, USA., Liang J; Department of Head and Neck Surgery, Kaiser Permanente East Bay, Oakland, California, USA.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2023 Jul; Vol. 169 (1), pp. 47-54. Date of Electronic Publication: 2023 Jan 29.
DOI: 10.1002/ohn.253
Abstrakt: Objective: There is anecdotal evidence SARS-CoV-2 (COVID) RT-PCR screening nasal swabs confer an elevated epistaxis risk. We aimed to assess the association between epistaxis and exposure to a COVID nasal swab.
Study Design: A matched pairs design was used.
Setting: The study was performed in a single, integrated health care system.
Methods: All patients who received a single COVID nasal swab at our institution between April 2020 and March 2021 were included. McNemar's test was used to compare rates of epistaxis between the 7 days following the index COVID swab (hazard period), and the 7 days preceding the index COVID swab (control period). Conditional logistic regression was used to evaluate sociodemographic and clinical risk factors for epistaxis.
Results: A total of 827,987 participants were included, with 1047 epistaxis encounters. The prevalence of epistaxis during the hazard and control periods were 0.08% and 0.04%, respectively. Swab exposure was associated with 1.92-fold odds of epistaxis during the hazard period (95% confidence interval [1.73, 2.12]). Older age, Asian/Pacific Islander (PI) (compared to white), male sex, hypertension, prior facial trauma, and warfarin or direct-acting oral anticoagulant use were also associated with significantly increased odds of epistaxis (p ≦ 0.01).
Conclusion: COVID nasal swabs are associated with increased odds of epistaxis. Physicians should counsel patients, particularly those at the highest risk, including a history of prior facial trauma, anticoagulants/antiplatelets, or hypertension.
(© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)
Databáze: MEDLINE
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