Covid: are nasopharyngeal swab tests dangerous?

Published by Cécile D. · Published on 10 April 2021 at 14h24
The Académie nationale de Médicine – or National Academy of Medicine – alerts on the potential danger of nasopharyngeal swab tests. These tests could cause “a breach in the anterior skull base associated with a risk of meningitis.

According to data released on February 4, 2021 by the Health Ministry, and since the Covid-19 epidemic broke out, 64 million tests have been made in France. These tests are carried out from nasopharyngeal swabs. But this is not risk-free, according to the National Academy of Medicine sharing concerns in a release issued this April 9, 2021.

The national Academy reminds these tests can cause breaches, often neglected because of the “normalization of nasopharyngeal swabs massively conducted in the Covid-19 context”. These complications (pain, bleeding) are often mild, but some of these breaches could lead to “severe complications starting to get described in the medical literature for a few weeks [including] breaches in the anterior skull base associated with a risk of meningitis”.

According to the institution, these side injuries are caused by swabs made in “unfit conditions”. To prevent these medical problems, the academy intended to detail the good practice to stick to when performing a test.

Anyone performing the test must start with “investigate before any swab about likely accidental or surgical history of the ENT area likely to alter the anatomy of the nasal and sinus cavities, especially surgeries involving the nasal septum, the lower nasal turbinates, and the paranasal sinus”. When performing the test, the health caregiver shall not “place the patient’s head in hyperextension during the test, but keep it in a natural position, the chin parallel to the floor”. And then, they can “put the swab horizontally to the bottom of the nasal cavity and absolutely not tilt it up towards the base of the skull”.

To make sure patients are correctly managed, the National Academy of Medicine recommends tests to be made by “health professionals trained to this action”. As for children, they better go for saliva tests.

The Academy also adds a memo about self-test kits likely to be put on sale soon in pharmacies: “self-test kits can lead to false negatives when the swabbing is too shy and superficial, but it can also become dangerous, when swabbing is too deep or in the wrong direction”.

Careful though if you choose this testing method.

Practical information