Biosafety in surgical pathology in the era of SARS-Cov2 pandemia. A statement of the Italian Society of Surgical Pathology and Cytology

Barbareschi, Mattia; Ascoli, Valeria; Bonoldi, Emanuela; Cavazza, Alberto; Colombari, Romano; Cozzi, Ilaria; Dainese, Emanuele; Facchetti, Fabio; Fadda, Guido; Ferrara, Gerardo; Fraggetta, Filippo; Graziano, Paolo; Murer, Giancarlo; Rossi, Esther Diana; Rossi, Giulio; Negri, Giovanni; Zannoni, Gianfranco; Sapino, Anna

doi:10.32074/1591-951x-14-20

Cited by 20 publications

(18 citation statements)

References 10 publications

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“…Cytological samples collected from COVID‐19 patients were processed according to the proposed guidelines, 10 and all the procedures were conducted by an experienced cytotechnician using appropriate personal protective equipment (masks, gloves, and a face shield) in a class II biosafety cabinet, as recommended 11 . Upon arrival at the pathology department, fresh pulmonary samples were fixed with 70% alcohol and 10% neutral buffered formalin for 12 hours.…”

Section: Methodsmentioning

confidence: 99%

Cytopathology of bronchoalveolar lavages in COVID‐19 pneumonia: A pilot study

Canini

Bono

Calzavacca

et al. 2021

Cancer Cytopathology

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BACKGROUND Bronchoalveolar lavage (BAL) in patients with severe coronavirus disease 2019 (COVID‐19) may provide additional and complementary findings for the management of these patients admitted to intensive care units (ICUs). This study addresses the cytological features of the infection and highlights the more influential inflammatory components. The correlation between pathological variables and clinical data is also analyzed. METHODS The authors performed a retrospective analysis of the cytopathological features of BAL in 20 COVID‐19 patients and 20 members of a matched cohort from a critical ICU who had acute respiratory distress syndrome caused by other pulmonary conditions. RESULTS A comparison of the controls (n = 20) and the COVID‐19 patients (n = 20) revealed that the latter had a higher neutrophil count (median, 63.8% of the cell count) with lower percentages of macrophages and lymphocytes. An increase in the expression of CD68‐positive, monocytic multinucleated giant cells (MGCs) was reported; megakaryocytes were not detected on CD61 staining. Perls staining showed isolated elements. In situ RNA analysis demonstrated scattered chromogenic signals in type II pneumocytes. An ultrastructural analysis confirmed the presence of intracytoplasmic vacuoles containing rounded structures measuring 140 nm in diameter (putative viral particles). In COVID‐19 patients, the clinicopathological correlation revealed a positive correlation between lactate dehydrogenase values and MGCs ( r = 0.54). CONCLUSIONS The analysis of BAL samples might be implemented as a routine practice for the evaluation of COVID‐19 patients in ICUs in the appropriate clinical scenario. Additional studies using a larger sample size of patients who developed COVID‐19 during the second wave of the epidemic in the autumn of 2020 are needed to further support our findings.

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Section: Methodsmentioning

confidence: 99%

Cytopathology of bronchoalveolar lavages in COVID‐19 pneumonia: A pilot study

Canini

Bono

Calzavacca

et al. 2021

Cancer Cytopathology

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“…As the virus can survive on paper up to 24 h, efforts should be made for paperless electronic request transmission. 2 From the literature published so far, it is clear that the major routes of transmission of COVID-19 are person-to-person transmission through air droplets, close contact with an infected individual or touching fomites that have been contaminated. 3 Since many of the cytology specimens have a high likelihood of generating aerosols or droplets, for example all respiratory specimens (such as Broncho alveolar lavages, bronchial brushings, bronchial washings, sputum, pleural fluids, EBUS-guided FNAs, and touch imprint slides from lung core biopsies), appropriate Personal Protective Equipment (PPE) should be worn prior to handling any specimen.…”

Section: Impact Of Covid-19 On Specimen Collection Handling Transport and Processingmentioning

confidence: 99%

The practice of cytopathology during the era of COVID-19: challenges and changes

Baskota¹,

Chandra²,

Cross³

2021

Diagnostic Histopathology

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This paper reviews the challenges faced by cytology laboratories during the COVID-19 pandemic. Various safety guidelines regarding collection, handling, transport and sampling in cytology laboratory are presented. A brief literature overview of adapted changes regarding new safety techniques, processing, sampling techniques implemented by the cytology laboratories in the this part of the world is presented. The use of cytology in COVID-19 patients is discussed. The authors have also tried to present the challenges and changes faced for training and education during this time. Migration from multi-headed scope in-person sign-out to digital based platforms were adapted to continue medical education. The potential long-term implications of these adaptations on cytology services are also touched upon.

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“…As described above, heat can also be used to inactivate coronaviruses [32]. However, it remains elusive whether fixatives applied in the preparation of cytology specimens using lower alcoholic concentrations [for example, PreservCyt® and CytoLyt® (Hologic Inc., USA)] adequately inactivate the SARS-CoV-2 virus [34]. Therefore, several aspects of SARS-CoV-2 remain unknown and fundamental questions concerning which disinfectants are most effective against it remain unanswered.…”

Section: Current Views On Sars-cov-2 Transmission Stability and Viricidal Methodsmentioning

confidence: 99%

The Anatomic Pathology laboratory adjustments in the era of COVID-19 pandemic: The experience of a laboratory in a Portuguese central hospital

Lamas¹,

Esteves²,

Alves³

et al. 2020

Annals of Diagnostic Pathology

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The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the world over the past weeks, with already 8,25 million infections and 445,000 deaths worldwide, leading to an unprecedented international global effort to contain the virus and prevent its spread. The emergence of novel respiratory viruses such as the SARS-CoV-2 creates dramatic challenges to the healthcare services, including surgical pathology laboratories, despite their extensive daily experience in dealing with biological and chemical hazards. Here, we cover important aspects on the knowledge on COVID-19 gathered during the first six months of the pandemic and address relevant issues on human biological sample handling in the Anatomic Pathology laboratory in the context of COVID-19 global threat. In addition, we detail our strategy to minimize the risk of contamination upon exposure to the different biological products received in the laboratory, which can be of general interest to other laboratories worldwide. Our approach has enabled a safe work environment for laboratory staff, while ensuring the maintenance of high quality standards of the work performed. In times of uncertainty and given the lack of specific guidelines directed at Anatomic Pathology services to better deal with the global COVID-19 publichealth emergency, it is essential to share with the community rigorous methodologies that will enable us to better cope with probable novel waves of COVID-19 infection and other viruses that will possibly arise in the near future.

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Biosafety in surgical pathology in the era of SARS-Cov2 pandemia. A statement of the Italian Society of Surgical Pathology and Cytology

Cited by 20 publications

References 10 publications

Cytopathology of bronchoalveolar lavages in COVID‐19 pneumonia: A pilot study

Cytopathology of bronchoalveolar lavages in COVID‐19 pneumonia: A pilot study

The practice of cytopathology during the era of COVID-19: challenges and changes

The Anatomic Pathology laboratory adjustments in the era of COVID-19 pandemic: The experience of a laboratory in a Portuguese central hospital

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