Why Do Some People Feel More Pain With Covid PCR Swab Tests Than Others?

May Some Patients Feel More Pain During Nasopharyngeal Covid-19 PCR Test?

The mucous membrane covering the inside of the nose is not very resistant to mechanical traumas, unlike our skin covering the outer part of our body. On the mucous membrane in the nose, there are mucus layer, cilia structure, free nerve endings, and glands.

Reactions such as feeling of pain, feeling of sneezing or coughing, tearing or an increase in nasal secretion secretion with a reflex mechanism, when any object (nasal swab used for covid test, q type, finger) is contacted with the mucous membrane in the nose. may occur.

In patients with nasal septum deviation, nasal valve collapse, turbinate hypertrophy, and intranasal mass, there may be more pain than normal when placing the nasal swab!

Nasal swabs inserted into the nose for the Covid-19 test should be advanced to the nasopharynx. In case of "nasal septum deviation, nasal valve stenosis, turbinate hypertrophy, intranasal mass" narrowing the passage on this route, trauma to the nasal mucosa, pain sensation and nose bleeding may occur.

Especially in patients who come for the treatment of nasal septum perforation, nasal swab placement after the closure of the nasal septum perforation may cause damage to the surgical area. For this reason, especially in patients who have recently undergone nasal surgery, it is necessary to advance the nasal swab parallel to the nasal septum as much as possible, and avoid diagonal movements. Some patients who have this test say that they can feel pain for days after the covid test, on the side of the narrow nasal airway. Especially in children, it is very important to keep the head still while the nasal swab is inserted into the nose.

Nose bleeding and pain in the nose after the covid test

It is ideal for patients who have nosebleeds and feel pain in the nose after nasal swab insertion for the Covid test, to pay attention to the following recommendations:

- The ends of the swabs used in the covid test are cotton-covered and soft. Nasal mucosal trauma is not expected to be very severe. You don't need to worry, but don't put your finger, tissue or q-tip into the nose for a few days, don't cause additional mechanical trauma by mixing your nose.
- For a few days, you can irrigate the nose with sprays containing natural ocean water. It is useful to squeeze 4 times a day.
- You can stay away from teas with diuretic properties, which can dry the nasal mucosa, and salty foods for a few days, and you can consume vegetables and fruits with high water content
- If you feel a lot of burning and pain in the nose, you can apply antibiotic eye ointment to the nose for a few days or use natural nasal moisturizing products.
- If the nosebleed is getting worse, you should consult an otolaryngologist.
- Attention should be paid to bleeding during the nasal swab test in patients with nosebleeds, who use aspirin or blood thinners, and who have a vascular area that tends to bleed in the nasal septum
- In the last 3 months of pregnancy, that is, in the last term cannabis, the intranasal airway may be narrower than normal as a result of the swelling of the mucous membranes in the nose due to the hormonal effect. For this reason, while performing the covid PCR test during pregnancy, pain may be felt more especially in pregnant women in the last line, and mucosal contact in the nose may be more than normal
- If the swab test stick is broken, or if the tip remains in the nose, it may fall into the mouth in the nasal region and you can spit out the part that fell into the mouth by tilting your head forward, or you can apply to an otolaryngologist for examination by staying in this position. In this case, if you inhale the air quickly by tilting your head back and forth, the risk of aspiration may occur.

Nasal swab test complications!

With the Covid-19 pandemic, millions of people were affected, and scientific studies on the test technique and swab placement began to be published about millions of covid 19 swab tests. You can take a look at the published scientific article about the breakage of the swab, the falling of the swab tip into the nose, the risk of aspiration, intranasal bleeding and damage >> "Complications of nasal and pharyngeal swabs: a relevant challenge of the COVID-19 pandemic?"

In these study, it was emphasized that the person responsible for the test should be knowledgeable and experienced, and should have knowledge of the anatomy of the nose while performing the covid 19 test.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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