Our Experience With Intractable Epistaxis After COVID-19 Nasopharyngeal Swab

TL;DR

This paper reports seven cases of severe nosebleeds after COVID-19 nasal swabs, showing how structural nasal issues can lead to life-threatening bleeding requiring surgery.

Contribution

The study identifies a link between nasal structural abnormalities and intractable epistaxis following nasopharyngeal swabs, emphasizing the need for better training.

Findings

Seven patients experienced intractable epistaxis after a nasopharyngeal swab.

Six of the seven cases had a deviated nasal septum, and all had bleeding from the affected side.

Sphenopalatine artery ligation successfully treated all cases.

Abstract

Introduction: Although a COVID-19 nasopharyngeal swab is a safe procedure routinely performed by healthcare providers, it can lead to complications that can be life-threatening. We present seven cases of intractable epistaxis following a nasopharyngeal swab that required sphenopalatine artery ligation. We aim to shed light on this life-threatening condition, emphasizing the importance of recognizing and mitigating such complications.

Materials and methods: This retrospective chart review involved cases of intractable epistaxis following a COVID-19 swab from January 2020 to June 2022. The patient's charts were reviewed for the location of the epistaxis and different intranasal and extranasal factors that could have led to it.

Results: Seven cases had intractable epistaxis following a nasopharyngeal COVID-19 swab. Six of the seven cases had a deviated nasal septum, and one case had an enlarged inferior turbinate. All patients had bleeding from the ipsilateral nasal structural abnormality. All patients underwent successful sphenopalatine artery ligation.

Conclusion: Our study highlights the significance of recognizing the potential risk of intractable epistaxis post-COVID-19 swabs and emphasizes the importance of comprehensive training programs to ensure the safe and effective execution of nasopharyngeal swab procedures.

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