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[Validity of SARS-CoV-2 swabs taken preoperatively in children]
Lena Zaubitzer1, Sonja Ludwig1, Frederic Jungbauer1
1HNO, Universitätsklinikum Mannheim, Germany.
Insights
Preoperative COVID-19 testing in children is unreliable due to poor compliance. Intraoperative testing is recommended when preoperative swabs are taken under difficult conditions to ensure operating room safety.
Area of Science:
- Pediatric infectious diseases
- Respiratory viral diagnostics
- Operating room safety protocols
Background:
- Collecting nasopharyngeal swabs in children is challenging due to limited compliance.
- Operations involving the upper respiratory tract pose a heightened risk of COVID-19 transmission in the operating room.
Purpose of the Study:
- To evaluate the accuracy of SARS-CoV-2 swabs collected preoperatively from pediatric patients under suboptimal conditions.
- To assess the reliability of COVID-19 testing in pediatric surgical settings.
Main Methods:
- A retrospective analysis compared preoperative and intraoperative pooled nasopharyngeal swab PCR results from 62 children (median age 4.49 years).
- Swabs were collected 1-2 days preoperatively (or same-day for emergencies) and intraoperatively between April and July 2020.
Main Results:
- All 62 preoperative swabs tested negative for SARS-CoV-2.
- One intraoperative swab yielded a positive result, contrasting with the preoperative findings.
Conclusions:
- The validity of preoperative SARS-CoV-2 swabs in children is questionable due to compliance issues affecting preanalytics.
- Enhanced protective measures are essential in operating rooms.
- Consider intraoperative testing when preoperative sample collection conditions are suboptimal.
Background:
Due to the limited compliance, the technically correct collection of a pooled nasopharyngeal swab is significantly more difficult in children. Especially during operations in the area of the upper respiratory tract, there is a significantly increased risk of infection with COVID-19 for everyone present in the operating room. The aim of the study is to analyze the validity of SARS-CoV-2 swabs taken preoperatively under suboptimal conditions.
Material And Methods:
Retrospective comparison of the PCR results of SARS-CoV-2 swaps taken preoperatively and intraoperatively from 62 children in the period from April to July 2020. Median age was 4.49 years. The PCR diagnosis was carried out one or two days preoperatively (in the case of emergency interventions on the same day) and again intraoperatively using a pooled nasopharyngeal swab.
Results:
All 62 preoperatively taken swabs were negative. Deviating from the preoperative test result, one intraoperatively obtained swab was positive.
Conclusions:
Due to limited compliance, a correct preoperative swab technique (preanalytics) cannot always be assumed for children. Sufficient protective measures for everyone present in the operating room are therefore imperative. Intraoperative test should be considered if the preoperative test was performed under difficult conditions.
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