Authors
Pasquale Di Maio, M.D.,1 Oreste Iocca, M.D., D.D.S.,2 Antonio Cavallero M.D.,1 Marco Giudice M.D.
1Giovanni Borea Civil Hospital, Department of Otolaryngology-Head and Neck Surgery, Sanremo, Italy 2Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (MI)
Corresponding author: Pasquale Di Maio, M.D. Giovanni Borea Civil Hospital, Via Giovanni Borea, 56, 18038, Sanremo (IM), Italy +39 3930200889 email:
dimaio.p86@aliceposta.it Acknowledgments
The authors would like to thank Dr. Giuseppe Garo, Dr. Cristina Ghirardi and Dr. Carlotta Tola for participating in the video recording. In addition, we are grateful to Ms. Rachel A. Elliott and Ms. Cristina Marconi for their support in editing the manuscript and video.
INTRODUCTION
Since its first appearance in Wuhan, China, in December 2019, the
SARS-CoV-2 virus responsible for coronavirus disease 2019 (COVID-19) has
progressively spread around the world.1 And to date
(April 15, 2020), according to the Johns Hopkins Coronavirus Resource
Center, the outbreak involved 185 countries worldwide, with 128,011
people dead.2 Healthcare workers were among the
hardest hit by this infection. This was evident from reports, both from
China and Italy, which revealed infection rates between medical staff
between 3.8 and 20%.1
The tests currently used for the direct identification of SARS-CoV-2 are
mainly aimed at detecting viral RNA through nucleic acid amplification,
generally using the polymerase chain reaction (PCR). The nasopharynx
and/or oropharynx are the most tested sampling sites using swabs, with a
slightly greater sensitivity shown by the nasopharyngeal
swab.3 This video shows the step-by-step procedure for
properly dressing and undressing, demonstrates how to wear the personal
protective equipment (PPE), and provides some technical notes on the
execution of the nasopharyngeal and oropharyngeal swab for COVID-19. All
of this serves to avoid the risk of contagion of the health worker. The
video is based on our experience at the Giovanni Borea Civic Hospital in
Sanremo, where in the last month, strictly following the CDC and WHO
guidelines,4,5 the otolaryngology team has performed
about 900 nasopharyngeal (95%) and oropharyngeal (5%) swabs. Following
these steps, none of the operators have been infected as of the present
date.