[Epistaxis Requiring Intervention After Swab for SARS-CoV-2]

Area of Science:

• Otolaryngology
• Infectious Disease Diagnostics

Background:

• Nasopharyngeal point-of-care (POC) tests for SARS-CoV-2 diagnosis became available in May 2020.
• The nasopharyngeal swab procedure carries a risk of injury and subsequent epistaxis due to the passage through the nasal cavity.

Purpose of the Study:

• To report on two cases of massive epistaxis following nasopharyngeal swabbing for SARS-CoV-2.
• To highlight potential life-threatening complications of nasopharyngeal swabbing.

Main Methods:

• Case report describing the clinical course of two female patients.
• Documentation of interventions required for severe epistaxis post-swabbing.

Main Results:

• One patient required sphenopalatine artery clipping after nasal tamponade.
• The second patient experienced hemorrhagic shock, requiring transfusion, intubation, and hospitalization.

Conclusions:

• Nasopharyngeal swabbing for SARS-CoV-2 can rarely lead to life-threatening epistaxis.
• Given the high volume of global testing, these complications require attention.
• Understanding nasal anatomy is crucial for safe swabbing; alternative, lower-risk testing methods should be explored.