In Reference to How to Reduce the Risk of Adverse Events After COVID-19 Nasopharyngeal Swab.

Abstract

I read the paper “CSF Leak After COVID-19 Nasopharyngeal Swab: A Case Report” by Paquin et al. and I think some recommendations can be added to optimize the procedural technique of nasopharyngeal swab to reduce the risk of adverse events: 1) to facilitate non-otolaryngologists, the floor of the nasal fossa (i.e., a line running from the nasal ala to the earlobe) should be parallel to the floor of the room; 2) slowly insert the swab down and posteriorly, following the direction of the floor of the nasal fossa; 3) the patient should be reminded not to move during collection of specimens; 4) ask the patient from which nostril she breathes best to understand which nostril is probably easier to pass through; 5) If the patient has a history of severe coagulopathy, ask her if she has had epistaxis and, if so, which side to obtain a nasopharyngeal swab specimen passing through the contralateral nasal cavity or, as an alternative, to obtain an oropharyngeal swab. In conclusion, I would like to thank Paquin for highlighting the need for educational of proper nasopharyngeal swab technique. I believe combining their recommendations with the tips I suggested may be useful to the readers and reduce the risk of adverse events.