A recent incident in the US, where a woman in her 40s underwent a COVID-19 nasal swab, which then led to a life-threatening infection. The woman developed runny nose, headache and vomiting soon after the PCR test, which required pushing a thin plastic nasal swab 3-4 inches along the floor of the nose through the nostril.
The woman went to the hospital, but her symptoms had gotten worse as she complained of a metallic taste in her mouth, neck stiffness and light sensitivity. After testing the liquid coming from her nose, clinicians found markers of brain fluid. After brain scans, it was revealed that the womanhood an encephalocele, a rare condition in which the bones of the skull don't close completely.
The condition had been a prevailing one, since at least 2017, but went undiagnosed. The nasal swab didn't cause the condition, but it sure aggravated it. As a result, cerebrospinal fluid leaked into the nose. This is also the first recorded incident of a brain fluid leak into the nose after a nasal swab test for COVID-19. Surgeons performed surgery to repair her skull and safely drained the fluids and are monitoring for any neurological side effects.
The woman's case is now a part of a study, which is reported in the journal JAMA Otolaryngology-Head & Neck Surgery. It highlights the importance of training clinicians and patients on how to conduct COVID-19 tests safely.
Should you worry?
No. This is no reason to not get tested if you've developed COVID symptoms. The brain has a lot of layers of protection and the plastic nasal swab will have to break through layers of thickly packed cells, multiple layers of tissue, then drill through a bone to reach the blood-brain barrier. It basically requires significant force.
The exception to this is an underlying condition similar to the one US woman presented. The woman had an undiagnosed soul defect that prevented the bones from closing completely.
"There is definitely a learning curve with the technique in terms of how much resistance one pushes against in the nose and therefore 'hurts' the patient. It is similar to playing the 'Operation' game, but blindly as most clinical personnel swabbing the nose are doing it without seeing inside the nose," Dr. Shawn Nasseri had told Business Insider.
The goal is to extract sputum to test for COVID-19 genes. The PCR test causes 5-8 seconds shock of unpleasantness. But if there are underlying conditions that may have altered the structure and strength of their nasal passage or skull, even expertly performed tests can lead to complications.