Patients with tracheostomies have an anatomically altered connection between their upper and lower airways that could impact SARS-CoV-2 testing. Smith and colleagues from the University of Michigan retrospectively compared the detection of SARS-CoV-2 in hospitalized patients with COVID-19 and tracheostomies.
The authors employed SARS-CoV-2 RNA nucleic acid
amplification test (NAAT) in 45 newly tracheotomized
patients in nasopharyngeal (NP) and tracheal (TR) samples taken within a
48-hour period.
Thirty-two (71.1%) of the 45 patients had entirely
concordant results after tracheostomy. However, 13 (28.9%) patients had at
least one set of discordant results, the majority of which were NP negative and
TR positive.
The authors concluded that patients with tracheostomies may
have a higher false-negative rate if only one site is assessed for SARS-CoV-2. They
recommend analyzing samples from both the nasopharynx and trachea for these
patients until more prospective data exist.
