Nasal Cerebrospinal Fluid Fistula after a Nasal Swab Test for COVID-19 in a Patient without Previous Nasosinusal Disease

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Good

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Good

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Good

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Very good

Comments: The case description is adequate. The Discussion section highlights that this case report is the first case in the literature regarding nasal cerebrospinal fluid (CSF) fistula after a nasal swab test for COVID-19 without the previous nasosinusal disease or functional endoscopic sinus surgeries (FESS). It briefly illustrates the clinical manifestations, diagnostic methods and the treatment of CSF fistula. The Discussion is well-supported with adequate relevant literature. Lastly, a conclusion is drawn that alerts patients and physicians about the possible risks of nasal swab test for the diagnosis of COVID-19.

Literature

Q: Does the author utilize relevant literature?

A: Good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Very good

Writing style

Q: Is it clear and understandable?

A: Good

Comments:

·       In the 2^nd sentence of the last paragraph of the Introduction, “is” should be replaced with “its” before “specificity”.

·       The 3^rd sentence of the 2^nd paragraph of the Discussion should be rephrased as “The aim is to control the levels of transmission of the disease appropriately… and isolation measures.”

·       Words like “nasosinusal”, “confirmed”, “with” are misspelled in the text section of the manuscript.

·       Articles are missing in several places throughout the text section of the manuscript.

Further comments on the paper

Comments: This case report describes the first case in the literature regarding nasal cerebrospinal fluid (CSF) fistula after a nasal swab test for COVID-19 in a 36-year-old healthy woman with no previous record of nasosinusal disease or functional endoscopic sinus surgeries (FESS). Although, β-2-transferrin test or β-trace-protein test are considered gold-standard diagnostic methods for rhinoliquorrhea, these exams could not be used due to the low availability of such tests in Brazil. Skull magnetic resonance imaging (MRI) confirmed the diagnosis of CSF fistula and high-resolution computed tomography (CT) determined the topographic location of CSF. The patient underwent endoscopic nasal surgery, and a nasal septal posteriorly based flap treated the fistula. This study showcases that despite samples being collected for testing, adverse events may still occur. It demonstrates the risk of an exceedingly rare complication of nasal swab testing for COVID-19 as well as recommends the need for clinical and surgical treatment for CSF fistula management.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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Thanks,
Science Repository Team