Let's get this out of the way first: Covid-19 tests are safe, only mildly uncomfortable, and you should get one if you have symptoms (depending of course on your government's current advice). However, a case report about one woman who ended up with a swab lodged in her lung following a test has been published by doctors, hoping to warn other medical professionals about the potential dangers involved in swabbing patients fitted with a tracheostomy. A 51-year-old patient in the UK was in the hospital for brain surgery, the team wrote in BMJ Case Reports. As part of her care, she required a tracheostomy tube – a catheter that is inserted into the windpipe through a hole created in the front of your neck in order to help you breathe. Before she was discharged to a nursing home following recovery, her team tested her for Covid-19, as per protocol in the UK. An experienced nurse attempted to get a mucosal swab through her tracheostomy tube, at which point she felt the swab snap. You probably don't need to be an experienced nurse to realize that's not great. The patient became unsettled and her oxygen saturation levels fell briefly, before returning to normal. She was taken for scans, which at first showed no signs of the swab, but signs of inflammation within the lungs. A further scan showed a narrowing of her airway due to the swab. The patient was taken for an endoscopy in order to remove the object, which was lodged in her lobar bronchus, the first subdivision of the main bronchi within the lungs. The object was successfully removed. The team hope that increased awareness among medical professionals will help prevent similar cases from happening again, though they believe that wearing full personal protective equipment and heightened concerns about contracting Covid-19 could increase the probability of human error occurring. "Patients with front of neck airways, either in the form of a laryngectomy or tracheostomy stoma site, present a challenge in terms of testing for SARS-CoV-2," they conclude in the case report. "There is a need for clear guidance on how to test patients with front of neck airways for SARS-CoV-2. This will be dependent on two main factors. First, how a front of neck airway affects the biodistribution of SARS-CoV-2 in the mucosa of the oropharynx and nasopharynx and second, understanding of the risk of increased aerosolisation associated with taking any sample from a tracheostomy site." Source
