Table 1

A summary of all included articles

First authorArticle typeTransnasal swab
method
Reported
complications (n)
Reported outcome(s)
Gupta4 LTENasopharyngealEpistaxis12
Nasal discomfort10
Headache7
Ear discomfort6
Rhinorrhea6
  • Majority of complications mild and self-limiting

  • A single case of epistaxis required presentation to the emergency department

Fabbris et al 5 LTENasopharyngealEpistaxis4
Retained swabs3
Nasal septal abscess1
  • Three cases of epistaxis required nasal packing under local anesthesia

  • Endoscopic cauterization and nasal packing under local anesthesia were required in the case of one epistaxis

  • Two retained swabs retrieved with nasal endoscopy

  • One retained swab was not located on nasal endoscopy and assumed swallowed

  • Nasal abscess incised and drained under local anesthesia

Pagella et al 6 LTENot applicableNot applicable
  • Patients with hemorrhagic telangiectasia should undergo non-transnasal SARS-CoV-2 testing

Föh7 LTENasopharyngeal
middle turbinate
Retained swabs2
TMJ dislocation1*
  • Adverse events were reported in 3 out of 11,476 swab procedures performed

  • One retained swab was endoscopically removed

  • One retained swab was not located on nasal endoscopy and assumed swallowed

Mughal8 Case reportNasopharyngealRetained swabs1
  • Retained swab retrieved with nasal endoscopy

Azar et al 9 Case reportNasopharyngealRetained swabs1
  • Retained swab retrieved with nasal endoscopy

Gaffuri et al 10 Case reportNasopharyngealRetained swabs1
  • Retained swab retrieved under general anesthesia using a bronchoscope with an operative channel and flexible endoscopy forceps

Medas11 Case reportNasopharyngealRetained swabs1
  • Retained swab not located on nasal endoscopy

  • An esophagogastroduodenoscopy was performed and swab located in stomach

  • Retrained swab removed using endoscope-grasping forceps

Sullivan et al 12 Case reportNasopharyngealCSF leak1
  • Required surgical repair of skull base defect

Alberola-Amores et al 13 Case reportNasopharyngealCSF leak complicated by meningitis1
  • Meningitis managed with antibiotics and steroids

  • Skull base defect closed spontaneously

Rajah14 Case reportNasopharyngealCSF leak1
  • Required surgical repair of skull base defect

  • *Local protocol required both transnasal and oropharynx testing with the swab. There was a reported case of mandibular dislocation due to mouth opening for oropharynx swabbing.

  • CSF, cerebrospinal fluid; LTE, letter to editor; TMJ, temporomandibular joint.