ABSTRACT
Background & objectives: The oropharyngeal (OP) and nasopharyngeal (NP) swab samples are the most recommended clinical specimens for detecting SARS-CoV-2 in an individual through the quantitative real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR) method. The primary objective of this study was to compare the performance of NP and OP swabs for the diagnosis of COVID-19 among 2250 concomitant samples (1125 NP + 1125 OP) using rRT-PCR test. Methods: This study was conducted at a tertiary care hospital in southern India. The study compared the specificity and efficacy of the two samples (NP & OP swabs) in 1125 individuals suspected having COVID-19 infection. The rRT-PCR values from all the samples were compared based on gender, age group and viral load. The differences between unmatched proportion and matched proportion were analysed. Agreement between the two methods was assessed using Kappa statistic. Absolute sensitivity, specificity, positive and negative predictive values (PPV and NPV) for OP and NP swabs were analysed. Results: The study identified a fair degree of agreement between OP and NP swabs in diagnosis of COVID-19 (kappa = 0.275, P <0.001). There was also a fair degree of agreement between NP and OP swabs irrespective of gender, age or duration of symptoms. NP swabs had better sensitivity and NPV as compared to OP swabs, however, specificity and PPV were 100 per cent for both. Interpretation & conclusions: The present study showed that both OP and NP swabs had similar sensitivity and specificity for predicting the presence of SARS-CoV-2.
Subject(s)
COVID-19 , Humans , SARS-CoV-2 , Nasopharynx , Oropharynx , Real-Time Polymerase Chain ReactionSubject(s)
Attitude to Health , Awareness , Betacoronavirus , Coronavirus Infections/epidemiology , Education, Medical/methods , Internship and Residency/methods , Pneumonia, Viral/epidemiology , Students, Medical/statistics & numerical data , COVID-19 , Clinical Competence , Humans , India/epidemiology , Pandemics , SARS-CoV-2ABSTRACT
The novel corona virus disease (COVID-19) has unfolded into a pandemic and is continuing to propagate at a frightening speed. The aim of this article is to share our protocol for performing a safe surgical tracheostomy in this COVID-19 era. Tracheostomy procedures have a high risk of aerosol generation. To standardize institutional safety measures with tracheostomy, we advocate using a dedicated tracheostomy protocol applicable to all patients including those suspected of having COVID-19. We also did explore the current literature and recommendations for tracheostomy in patients with COVID-19 and studied the previous data from severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1), the virus responsible for the SARS outbreak of 2003. We have prepared a protocol for performing a safe surgical tracheotomy in patients affected by COVID-19. Surgeons who might be involved in performing the tracheostomies should become familiar with these guidelines.