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