Inconsistent Polymerase Chain Reaction Test Results From the Upper And Lower Airways of a Patient Who Underwent Total Laryngectomy During the Incubation Period for Coronavirus Disease

Abstract

On March 11, 2020, the World Health Organization declared coronavirus disease (COVID-19), an infection caused by SARS-CoV-2, a pandemic. There have been reports of differences in the results of COVID-19 tests of patients who underwent total laryngectomy, depending on the sample collection site. The upper respiratory tract mucosa or saliva is the recommended sample collection site for an initial diagnosis. However, in some patients who underwent total laryngectomy, only samples from the lower respiratory tract tested positive. We report the case of a patient who was preoperatively infected with COVID-19. He underwent a total laryngectomy during the incubation period, and tested positive using a sample collected from the upper respiratory tract. Of a total of six polymerase chain reaction tests performed using samples from both the upper and lower respiratory tract, two had inconsistent results. The patient developed COVID-19 pneumonia and was successfully managed with antiviral medication. No postoperative complications were observed.