key: cord-0692884-bkryhbhi
authors: Takahashi, Kazuomi; Okachi, Shotaro; Yasui, Hirotoshi; Taki, Shunichi; Ito, Takayasu; Fukatsu, Noriaki; Sato, Kazuhide
title: New style for nasopharyngeal swab: image-evaluation
date: 2021-06-22
journal: Int J Infect Dis
DOI: 10.1016/j.ijid.2021.06.039
sha: 0485da33bf62ab0dba639a0d8ce26b23d269f288
doc_id: 692884
cord_uid: bkryhbhi

nan

Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly spreading worldwide and has become a threat to humankind. Respiratory infectious viruses such as SARS-CoV-2 are transmitted via contact and droplets and have a high secondary attack rate ranging from 3.0-11.2% in households (Wiersinga et al., 2020) . Diagnosis of respiratory infectious virus is performed by collecting specimens from the surface of the respiratory mucosa using nasopharyngeal swabs (Föh et al., 2020; Marty et al., 2020) . However, it is a high-risk procedure for healthcare workers because it causes pharyngeal reflexes or sneezing. We have developed a new mask that patients can wear when undergoing nasopharyngeal 4 swab collection to reduce the infectious risk for healthcare workers. The mask was originally developed for use in endoscopy. It has a 10-mm-slit in the center to insert the bronchoscope and a 6-mm-slit on both sides for the suction catheter (figure 1A). The patient (the mannequin) wore this mask slightly above the usual level, and the examiner inserted a pharyngeal swab through the 10-mm hole ( figure 1B) . This method is thought to be effective in preventing airborne droplets exposure. We evaluated the protective effect of the mask using a highly sensitive camera and a high-power light source (ViEST system) that can visualize airborne particles over 80 nm in size and visually confirmed the protective effect of the mask ( figure 1C and supplementary video) .

Moreover, for the precise evaluation of the protective effect with the mask, we did the visualization three times. Quantification of the pixels of airborne particles from the visualizations indicated that significant reduction of airborne particles with the mask (p = 0.0132 < 0.05, Student's t-test). This mask has several other advantages; the patient does not feel uncomfortable while wearing this mask because its basic structure is similar to that of surgical masks. It is disposable and thus contributes to the prevention of sample contamination. However, there is a concern. Since the mask inhibits the visualization of the proper swab collection, the swab collector would have to be trained.

In conclusion, this mask is a simple and valuable protective tool. The use of this mask by patients and conventional infection prevention measures has preventative benefits during nasopharyngeal swabs collection.

S.O. H.Y. and K.S. have patent pending.

This research was supported by the Nagoya University Dean fund for B3, Yahoo Japan kikin against COVID-19, and KAKEN (grant numbers 18K15923 and 21K07217) (JSPS), CREST (JPMJCR19H2, JST) and FOREST-Souhatsu (JST) to K.S. Funders only provided funding, and had no role in the study design, data collection, data analysis, interpretation, and writing of the report.

All authors are equally contributed to this work. K.T., S.O.,H.Y., T.I., and K.S. mainly conducted the experiment and wrote the manuscript, N.F., S.T., performed image analysis. K.S. supervised, designed, conceived and conducted all the project.

The research protocol was reviewed and approved by the Ethics Committee of the Nagoya University Clinical Research Committee (Approval No. 2020-0127) . This article does not contain any studies with human participants performed by any of the authors.

The subject man of the experiment was consented by signature of this publication

Not applicable Figure 1 (A) Scheme of a mask for nasopharyngeal swab (left). The mask had a 10-mm-slit in the center for swab stick insertion and a 6-mm-slit on both sides for the suction tube (right).

(B) The appearance of the swab-test-mannequin with or without the mask (left and center pictures). Nasopharyngeal swab can easily insert in the slit (right picture).

(C) High speed sensitive camera images (ViEST system) of splashes during coughing without and with the swab-mask (See supplementary Video1). The mask can prevent the splashes and droplets.

Complications of nasal and pharyngeal swabs -a relevant challenge of the COVID-19 pandemic?

How to Obtain a Nasopharyngeal Swab Specimen

Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review

We thank to Mr. Akinori Terazawa and Mr. Takanao Yokoi in Shirohao Co., Ltd. for industrial mask production. We also thank to Mr. Ryuta Okamoto and Kozo Takahashi for the ViEST System. We thank to Mr. Kazuhiko Kogo, and MS. Nahoko Sakaguchi, Nagoya University URA.

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.