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Asystole During Nasopharyngeal Swab: Is COVID-19 to Blame?
Cureus (2021)
  • Luai Madanat, Beaumont
  • Amal Khalife, Beaumont
  • Matthew Sims, Beaumont
Abstract
The use of nasopharyngeal (NP) swab sampling for the detection of various respiratory pathogens has been a standard procedure in medicine for many years. While this is a fairly common procedure, there has been a significant increase in utilization recently due to the SARS-CoV-2 pandemic. We describe a case of a 40-year-old SARS-CoV-2 positive patient with no prior cardiac history who developed asystole while an NP swab was being used to obtain a sample for a SARS-CoV-2 assay. Return of normal sinus rhythm was achieved with chest compressions alone. The incident was deemed to have been an exaggerated vagal response to intranasal stimulation; better known as the trigeminocardiac reflex. This is the first reported case describing asystole during use of an NP swab. This case occurred in a patient with no known cardiac disease and highlights the potential importance of the arrhythmogenic nature of COVID-19 that could potentiate the vagal response in susceptible individuals undergoing NP sampling.
Keywords
  • arrhythmias,
  • asystole,
  • covid 19,
  • nasopharyngeal swab,
  • sars-cov-2,
  • trigeminocardiac reflex,
  • vagal response
Disciplines
Publication Date
June 4, 2021
DOI
10.7759/CUREUS.15448
Citation Information
Madanat L, Khalife A, Sims M. Asystole During Nasopharyngeal Swab: Is COVID-19 to Blame? Cureus. 2021 Jun 4;13(6):e15448. doi: 10.7759/cureus.15448. PMID: 34249579; PMCID: PMC8253460.