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2.
Cancer Cytopathol ; 130(5): 344-351, 2022 05.
Article in English | MEDLINE | ID: covidwho-1615950

ABSTRACT

BACKGROUND: In a previous worldwide survey, the authors showed a drastic reduction in the number of cytological specimens processed during the coronavirus disease 2019 "lockdown" period along with an increase in malignancy rates. To assess the continued impact of the pandemic on cytological practices around the world, they undertook a second follow-up worldwide survey collecting data from the post-lockdown period (2020). METHODS: Participants were asked to provide data regarding their cytopathology activity during the first 12 weeks of their respective national post-lockdown period (2020), which ranged from April 4 to October 31. Differences between the post-lockdown period and the corresponding 2019 period were evaluated, and the authors specifically focused on rates of malignant diagnoses. RESULTS: A total of 29 respondents from 17 countries worldwide joined the survey. Overall, a lower number of cytological specimens (n = 236,352) were processed in comparison with the same period in 2019 (n = 321,466) for a relative reduction of 26.5%. The overall malignancy rate showed a statistically significant increase (12,442 [5.26%] vs 12,882 [4.01%]; P < .001) during the same time period. Similar results were obtained if both malignancy and suspicious for malignancy rates were considered together (15,759 [6.58%] vs 16,011 [4.98%]; P < .001). CONCLUSIONS: The data showed a persistent reduction in the cytological specimen volume during the post-lockdown period (2020). However, the relative increase in the cytological workload in the late part of the post-lockdown is a promising finding of a slow return to normality.


Subject(s)
COVID-19 , Neoplasms , COVID-19/epidemiology , Communicable Disease Control , Humans , Neoplasms/diagnosis , Neoplasms/epidemiology , Pandemics/prevention & control , SARS-CoV-2
3.
Cytopathology ; 33(1): 93-99, 2022 01.
Article in English | MEDLINE | ID: covidwho-1365068

ABSTRACT

BACKGROUND: The global pandemic of the coronavirus disease 2019 represents a major concern for health services worldwide, and has also induced major changes in cytopathology practice. AIM: We aimed to verify the diagnostic performance of cytological evaluation under a new safety protocol during the pandemic compared to the standard pre-pandemic procedure. We also aimed to assess how cytological diagnoses and sampling were impacted during the pandemic period compared to the pandemic-free period in 2019. MATERIALS AND METHODS: Cytological samples of peritoneal washings taken during the first 10 months of the pandemic emergency in Italy (March 11, 2020 to January 11, 2021) were compared to samples from the preceding 10-month time frame (May 11, 2019 to March 10, 2020). RESULTS: One hundred ninety-five specimens were analysed in the present study. We observed no noticeable differences in cytological diagnoses during the pandemic period compared to the pre-pandemic period. The case numbers by diagnostic category for the pre-pandemic vs pandemic periods, respectively, were as follows: non-diagnostic, 0 vs 0 cases; negative for malignancy, 86 vs 52 cases; atypia of uncertain significance, 7 vs 1 cases; suspicious for malignancy, 0 vs 2 cases; malignant, 42 vs 4 cases. CONCLUSION: While a consistent reduction in the number of cytological examinations has been observed during the COVID-19 period, our institutional safety protocol for processing cytological samples did not affect the diagnostic reliability of peritoneal washing cytology.


Subject(s)
COVID-19/diagnosis , Cytodiagnosis , Cytological Techniques , SARS-CoV-2/pathogenicity , COVID-19/complications , Cytological Techniques/methods , Humans , Italy , Neoplasms/pathology , Specimen Handling/methods
5.
Pathologica ; 112(4): 174-177, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1022379

ABSTRACT

Up to now, Italy is one of the European centers with the most active Coronavirus cases with 233,836 positive cases and 33,601 total deaths as of June 3rd. During this pandemic and dramatic emergency, Italian hospitals had also to face neoplastic pathologies, that still afflict the Italian population, requiring urgent surgical and oncological treatment. In our Cancer Center Hospital, the high volume of surgical procedures have demanded an equally high volume of intraoperative pathological examinations, but also posed an additional major challenge for the safety of the staff involved. The current commentary reports our experience in the past two months (since March 9th) for a total of 1271 frozen exams from 893 suspect COVID-19 patients (31 confirmed).


Subject(s)
COVID-19 , Containment of Biohazards/standards , Intraoperative Care/standards , Pandemics , Pathology/standards , COVID-19/epidemiology , Humans , Intraoperative Care/statistics & numerical data , Italy/epidemiology , Middle Aged , Pathology/statistics & numerical data
6.
Cancer Cytopathol ; 128(12): 885-894, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-893212

ABSTRACT

BACKGROUND: To the authors' knowledge, the impact of the coronavirus disease 2019 (COVID-19) pandemic on cytopathology practices worldwide has not been investigated formally. In the current study, data from 41 respondents from 23 countries were reported. METHODS: Data regarding the activity of each cytopathology laboratory during 4 weeks of COVID-19 lockdown were collected and compared with those obtained during the corresponding period in 2019. The overall number and percentage of exfoliative and fine-needle aspiration cytology samples from each anatomic site were recorded. Differences in the malignancy and suspicious rates between the 2 periods were analyzed using a meta-analytical approach. RESULTS: Overall, the sample volume was lower compared with 2019 (104,319 samples vs 190,225 samples), with an average volume reduction of 45.3% (range, 0.1%-98.0%). The percentage of samples from the cervicovaginal tract, thyroid, and anorectal region was significantly reduced (P < .05). Conversely, the percentage of samples from the urinary tract, serous cavities, breast, lymph nodes, respiratory tract, salivary glands, central nervous system, gastrointestinal tract, pancreas, liver, and biliary tract increased (P < .05). An overall increase of 5.56% (95% CI, 3.77%-7.35%) in the malignancy rate in nongynecological samples during the COVID-19 pandemic was observed. When the suspicious category was included, the overall increase was 6.95% (95% CI, 4.63%-9.27%). CONCLUSIONS: The COVID-19 pandemic resulted in a drastic reduction in the total number of cytology specimens regardless of anatomic site or specimen type. The rate of malignancy increased, reflecting the prioritization of patients with cancer who were considered to be at high risk. Prospective monitoring of the effect of delays in access to health services during the lockdown period is warranted.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/standards , Laboratories, Hospital/statistics & numerical data , Pathology, Clinical/statistics & numerical data , Workload/statistics & numerical data , Biopsy, Fine-Needle/statistics & numerical data , COVID-19/epidemiology , COVID-19/virology , Humans , Laboratories, Hospital/trends , Pathology, Clinical/trends , SARS-CoV-2/pathogenicity , Societies, Medical/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data
7.
Cancer Cytopathol ; 128(12): 905-909, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-696749

ABSTRACT

BACKGROUND: Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and represents the causative agent of a potentially fatal disease. The spread of the infection and the severe clinical disease have led to the widespread adoption of social distancing measures. Special attention and efforts to protect or reduce transmission have been applied at all social levels, including health care operators. Hence, this reports focuses on the description of a new protocol for the safe management of cytological samples processed by liquid-based cytology (LBC) with an evaluation of the changes in terms of morphology and immunoreactivity. METHODS: From March 11 to April 25, 2020, 414 cytological cases suspicious for SARS-CoV-2 were processed with a new virus-inactivating method suggested by Hologic, Inc, for all LBC specimens. RESULTS: The samples showed an increased amount of fibrin in the background. A slight decrease in cellular size was also observed in comparison with the standard method of preparation. Nonetheless, the nuclear details of the neoplastic cells were well identified, and the immunoreactivity of the majority of those cells was maintained. The cell blocks did not show significant differences in morphology, immunoreactivity, or nucleic acid stability. CONCLUSIONS: Despite some minor changes in the morphology of the cells, the results of this study highlight that the adoption of the new protocol for the biosafety of LBC-processed samples in pathology laboratories is important for minimizing the risk for personnel, trainees, and cytopathologists without impairing the diagnostic efficacy of the technique.


Subject(s)
COVID-19/diagnosis , Containment of Biohazards/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Laboratories, Hospital/standards , Specimen Handling/standards , COVID-19/pathology , COVID-19/prevention & control , COVID-19/transmission , Clinical Protocols/standards , Containment of Biohazards/trends , Histocytological Preparation Techniques/methods , Histocytological Preparation Techniques/standards , Humans , Laboratories, Hospital/trends , Liquid Biopsy , Pandemics/prevention & control , Pathologists/standards , Pathology, Clinical/standards , Personal Protective Equipment/standards , Risk Factors , SARS-CoV-2/isolation & purification , Specimen Handling/methods
8.
Cancer Cytopathol ; 128(5): 317-320, 2020 May.
Article in English | MEDLINE | ID: covidwho-38690

ABSTRACT

The 2019 coronavirus pandemic, which started in Wuhan, China, spread around the globe with dramatic and lethal effects. From the initial Chinese epicenter, the European diaspora taxed the resources of several countries and especially those of Italy, which was forced into a complete social and economic shutdown. Infection by droplets contaminating hands and surfaces represents the main vehicle of diffusion of the virus. The common and strong efforts to contain the pandemic have relevant effects on the management of samples from histopathology laboratories. The current commentary reports and focuses on the protocols and guidelines in use at a large tertiary Italian hospital that accordingly are proposed for adoption in Italian laboratories as a potential model for national guidelines for the coronavirus emergency.


Subject(s)
Containment of Biohazards/methods , Coronavirus Infections/pathology , Cytological Techniques/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pneumonia, Viral/pathology , COVID-19 , Containment of Biohazards/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Cytological Techniques/standards , Humans , Infection Control/methods , Infection Control/standards , Italy , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology
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