Daniel B Vinh MD 1 , Xiao Zhao MD PhD*,2, Kimberley L Kiong MBBS 2 , Theresa Guo MD 2 , Yelda Jozaghi MD 2 , Chris Yao MD 2 , James M Kelley MD PhD 3 , Ehab Hanna MD 2
1 Department of Otolaryngology – Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA 2 Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA 3 Department of Laboratory Medicine, Division of Pathology and Laboratory Medicine, MD Anderson Cancer Center, Houston, TX, USA
Key words: COVID-19, PCR, sensitivity, SARS-CoV-2, testing
Abstract
Background : Testing for SARS-CoV-2 is important for decision
making prior to surgery in otolaryngology. An understanding of current
and developing testing methods is important for interpreting test
results.
Methods : We performed a literature review of current evidence
surrounding SARS-CoV-2 diagnostic testing highlighting its utility,
limitations, and implications for otolaryngologists.
Results : The currently accepted RT-PCR test for SARS-CoV-2 has
varying sensitivity according to which subsite of the aerodigestive
tract is sampled. Nasal swab sensitivities appear to be about 70%.
Chest CT imaging for screening purposes is not currently recommended.
Conclusion : Due to the current sensitivity of RT-PCR based
testing for SARS-CoV-2, a negative test cannot rule out COVID-19. Full
PPE should be worn during high risk procedures such as aerosol
generating procedures even if testing is negative. Patients who test
positive during screening should have their surgeries postponed if
possible until asymptomatic and have tested negative for SARS-CoV-2.