Rates of PCR Positivity of Pleural Drainage Fluid in COVID-19 Patients: Is It Expected?

ingentiumby ingentium

In Clinical Literature.

Publication date: Dec 08, 2024

Tube thoracostomy, utilized through conventional methodologies in the context of pleural disorders such as pleural effusion and pneumothorax, constitutes one of the primary therapeutic interventions. Nonetheless, it is imperative to recognize that invasive procedures, including tube thoracostomy, are classified as aerosol-generating activities during the management of pleural conditions in patients afflicted with COVID-19, thus raising substantial concerns regarding the potential exposure of healthcare personnel to the virus. The objective of this investigation was to assess the SARS-CoV-2 viral load by detecting viral RNA in pleural drainage specimens from patients who underwent tube thoracostomy due to either pleural effusion or pneumothorax. In this single-center prospective cross-sectional analysis, a real-time reverse transcriptase (RT) polymerase chain reaction (PCR) assay was employed to conduct swab tests for the qualitative identification of nucleic acid from SARS-CoV-2 in pleural fluids acquired during tube thoracostomy between August 2021 and December 2021. All pleural drainage specimens from 21 patients who tested positive for COVID-19 via nasopharyngeal PCR, of which 14 underwent tube thoracostomy due to pneumothorax, 4 due to both pneumothorax and pleural effusion, and 3 due to pleural effusion, were found to be negative for SARS-CoV-2 RNA. Moreover, individuals exhibiting pleural effusion were admitted to the intensive care unit with a notably higher incidence, yet demonstrated significantly more radiological anomalies in patients diagnosed with pneumothorax. The current findings, inclusive of the results from this study, do not furnish scientific evidence to support the notion that SARS-CoV-2 is transmitted via aerosolization during tube thoracostomy, and it remains uncertain whether the virus can be adequately contained within pleural fluids.

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Concepts Keywords
August COVID-19
December pleural fluid
Qualitative pneumothorax
Thoracostomy SARS-CoV-2 PCR
Viral tube thoracostomy

Semantics

Type Source Name
disease MESH COVID-19
disease MESH pleural effusion
disease MESH pneumothorax
disease MESH viral load
disease IDO assay
disease IDO nucleic acid
disease MESH anomalies
drug DRUGBANK Clotiazepam
drug DRUGBANK Coenzyme M
pathway REACTOME Metabolism
disease MESH inflammation
disease MESH bacterial infections
disease MESH critical illness
disease MESH hepatitis
disease MESH infection
disease MESH peritoneal fluids
disease MESH emergency
disease IDO intervention
disease IDO history
disease MESH heart failure
disease MESH cirrhosis
disease MESH chronic renal failure
disease IDO country
drug DRUGBANK Cefoxitin
disease MESH empyema
disease IDO protein
drug DRUGBANK Dextrose unspecified form
drug DRUGBANK Creatinine
disease MESH bile
disease IDO facility
disease MESH complications
disease MESH renal failure
disease MESH pulmonary embolism
disease MESH viral infection
disease MESH hypoalbuminemia
disease MESH viral pneumonia
disease MESH lymphopenia
disease IDO blood
disease IDO replication
pathway KEGG Viral replication
disease IDO pathogen
disease MESH morbidity
disease MESH Pleural Diseases
disease MESH Pneumonia
drug DRUGBANK Vorinostat
disease IDO immunodeficiency
drug DRUGBANK (S)-Des-Me-Ampa
drug DRUGBANK Troleandomycin

Original Article

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