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

* Corresponding author. E-mail: XZhao6@mdanderson.org

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.