False‐positive Reverse Transcriptase Polymerase Chain Reaction Screening for SARS‐CoV‐2 in the Setting of Urgent Head and Neck Surgery and Otolaryngologic Emergencies during the Pandemic: Clinical Implications

Authors

Andrew P. Katz, University of Miami Miller School of Medicine
Francisco J. Civantos, University of Miami Miller School of Medicine
Zoukaa Sargi, University of Miami Miller School of Medicine
Jason M. Leibowitz, University of Miami Miller School of Medicine
Elizabeth A. Nicolli, University of Miami Miller School of Medicine
Donald Weed, University of Miami Miller School of Medicine
Alexander E. Moskovitz, University of Miami Miller School of Medicine
Alyssa M. Civantos, Perelman School of Medicine at the University of Pennsylvania
David M. Andrews, University of Miami Miller School of Medicine
Octavio Martinez, University of Miami Miller School of Medicine
Giovana R. Thomas, University of Miami Miller School of Medicine

Document Type

Article

Publication Date

7-2020

Keywords

COVID‐19, head and neck surgery, pandemic, preoperative testing, RT‐PCR

DOI

https://doi.org/10.1002/hed.26317

Abstract

Background: No reports describe falsepositive reverse transcriptase polymerase chain reaction (RT‐PCR) for novel coronavirus in preoperative screening.

Methods: Preoperative patients had one or two nasopharyngeal swabs, depending on low or high risk of viral transmission. Positive tests were repeated.

Results: Forty‐three of 52 patients required two or more preoperative tests. Four (9.3%) had discrepant results (positive/negative). One of these left the coronavirus disease (COVID) unit against medical advice despite an orbital abscess, with unknown true disease status. The remaining 3 of 42 (7.1%) had negative repeat RT‐PCR. Although ultimately considered falsepositives, one was sent to a COVID unit postoperatively and two had urgent surgery delayed. Assuming negative repeat RT‐PCR, clear chest imaging, and lack of subsequent symptoms represent the “gold standard,” RT‐PCR specificity was 0.97.

Conclusions: If false positives are suspected, we recommend computed tomography (CT) of the chest and repeat RT‐PCR. Validated serum immunoglobulin testing may ultimately prove useful.

Comments

Article available for free at PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307014/

Citation / Publisher Attribution

Head & Neck, v. 42, issue 7, p. 1621-1628

Scholar Commons Citation

Katz, Andrew P.; Civantos, Francisco J.; Sargi, Zoukaa; Leibowitz, Jason M.; Nicolli, Elizabeth A.; Weed, Donald; Moskovitz, Alexander E.; Civantos, Alyssa M.; Andrews, David M.; Martinez, Octavio; and Thomas, Giovana R., "False‐positive Reverse Transcriptase Polymerase Chain Reaction Screening for SARS‐CoV‐2 in the Setting of Urgent Head and Neck Surgery and Otolaryngologic Emergencies during the Pandemic: Clinical Implications" (2020). All publications. 47.
https://digitalcommons.usf.edu/usf_fcrc_all/47