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

Autor: Alyssa M. Civantos, Andrew P. Katz, Zoukaa Sargi, Giovana R. Thomas, Francisco J. Civantos, Elizabeth A. Nicolli, Octavio Martinez, Alexander E. Moskovitz, David M. Andrews, Donald T. Weed, Jason M. Leibowitz
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
RT‐PCR
Pneumonia
Viral
Disease
medicine.disease_cause
Preoperative care
head and neck surgery
03 medical and health sciences
Betacoronavirus
Young Adult
0302 clinical medicine
COVID‐19
Internal medicine
Nasopharynx
Preoperative Care
medicine
False positive paradox
Humans
False Positive Reactions
030212 general & internal medicine
Young adult
Lung
Pandemics
Coronavirus
preoperative testing
Aged
80 and over
business.industry
Special Issue
Reverse Transcriptase Polymerase Chain Reaction
SARS-CoV-2
pandemic
COVID-19
Gold standard (test)
Middle Aged
Reverse transcriptase
Otorhinolaryngologic Surgical Procedures
Real-time polymerase chain reaction
Otorhinolaryngology
030220 oncology & carcinogenesis
Florida
RNA
Viral
Female
Emergencies
business
Coronavirus Infections
Tomography
X-Ray Computed
Zdroj: Head & Neck
ISSN: 1097-0347
1043-3074
Popis: 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.
Databáze: OpenAIRE
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