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코로나바이러스 감염증-19 진단검사에 위음성을 보인 후두전절제 환자 1예

A Case of False Negativity With COVID-19 Diagnostic Test in Total Laryngectomee

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초록

The coronavirus disease (COVID-19) by severe acute syndrome coronavirus-2 (SARS-CoV-2) occurs the unprecedented pandemic during recent two years and the WHO declared a global pandemic of COVID-19 in March 2020. The most common sampling sites in COVID-19 test are the oropharynx and nasopharynx. We recently encountered a total laryngectomee who had a positivity COVID-19 diagnostic test from the tracheostoma, on the other hand, false negativity from the nasal cavity. The meaning of this case is that accurate screening test could be achieved by performing a test through the tracheostoma as well as nasal cavity or oropharynx. We also would like to discuss the accurate testing methods of patients whose airflow has distorted due to surgery, the management method of these patients, and the need of further research in the COVID-19 pandemic period with relevant literature reviews.

Abstract

The coronavirus disease (COVID-19) by severe acute syndrome coronavirus-2 (SARS-CoV-2) occurs the unprecedented pandemic during recent two years and the WHO declared a global pandemic of COVID-19 in March 2020. The most common sampling sites in COVID-19 test are the oropharynx and nasopharynx. We recently encountered a total laryngectomee who had a positivity COVID-19 diagnostic test from the tracheostoma, on the other hand, false negativity from the nasal cavity. The meaning of this case is that accurate screening test could be achieved by performing a test through the tracheostoma as well as nasal cavity or oropharynx. We also would like to discuss the accurate testing methods of patients whose airflow has distorted due to surgery, the management method of these patients, and the need of further research in the COVID-19 pandemic period with relevant literature reviews.

참고문헌 (9)

  1. Lee KH, "Laboratory diagnosis of COVID-19 in Korea", Ewha Med J, 44(1), pp.1~10 (2021)
  2. Czech J, "Diagnostic difficulties with COVID-19 in a patient after total laryngectomy", Pol Otorhino Rev, 10(2), pp.44~47 (2021)
  3. Schmid J, "Sampling site matters when testing for COVID-19 after total laryngectomy : A case report", Wien Klin Wochenschr, 133(7-8), pp.416~417 (2021)
  4. Smith JD, "Discordant SARS-CoV-2 detection in the nasopharynx versus trachea for patients with tracheostomies", Laryngoscope, 131(10), pp.E2634~E2638 (2021)
  5. Sungnak W, "SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes", Nat Med, 26(5), pp.681~687 (2020)
  6. Ricciardiello F, "Covid-19 laryngectomized patients care, on field experience, and considerations", Clin Case Rep, 9(4), pp.2094~2098 (2021)
  7. Patel TR, "Disparate nasopharyngeal and tracheal COVID-19 diagnostic test results in a patient with a total laryngectomy", Otolaryngol Head Neck Surg, 163(4), pp.710~711 (2020)
  8. Hamed I, "Paired nasopharyngeal and deep lung testing for severe acute respiratory syndrome coronavirus-2 reveals a viral gradient in critically ill patients : A multicenter study", Chest, 159(4), pp.1387~1390 (2021)
  9. Hennessy M, "Commentary on the management of total laryngectomy patients during the COVID-19 pandemic", Head Neck, 42(6), pp.1137~1143 (2020)

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