Characteristics of SARS-CoV-2, COVID-19, and laboratory diagnosis / Características del SARS-CoV-2, COVID-19 y su diagnóstico en el laboratorio

La enfermedad COVID­19 es causada por el virus SARS-CoV-2, descrito por primera vez en diciembre del 2019 en Wuhan, China, y declarada en marzo del 2020 como una pandemia mundial. Actualmente existen diversos métodos diagnósticos para COVID-19, siendo el estándar de oro la detección del material genético mediante la reacción en cadena de la polimerasa (PCR), en su variante, la RT-PCR, que detecta el material genético de tipo ARN presente en el virus. Sin embargo, es necesario disponer de pruebas rápidas con alta sensibilidad y precisión para realizarlas a gran escala y brindar un diagnóstico oportuno. Adicionalmente, se debe disponer de otras herramientas que, si bien no van a establecer un diagnóstico, le van a permitir al profesional brindar un mejor manejo clínico y epidemiológico que ayuden a predecir el agravamiento del paciente y su posible ingreso a UCI, destacando entre estas los niveles de dímero D, linfocitos, ferritina, urea y creatinina, entre otras. En esta revisión se evalúa la utilidad y limitaciones de los diferentes métodos diagnósticos para COVID-19, al igual que las características, fisiopatología y respuesta inmune al SARS-CoV-2, así como algunos aspectos preanalíticos de importancia que ayudan a minimizar errores en el diagnóstico como consecuencia de procedimientos incorrectos en la toma, transporte y conservación de la muestra, y que permiten al profesional emitir resultados veraces y confiables. Lo anterior se realizó basado en artículos originales, revisiones y guías clínicas

COVID­19 is caused by the SARS-CoV-2 virus, first described in December 2019 in Wuhan, China, and declared a global pandemic in March 2020. Currently there are various diagnostic methods for COVID-19, the gold standard is the detection of genetic material through polymerase chain reaction (PCR) in its variant, RT-PCR, which detects RNA-type genetic material present in the virus. However, it is necessary to have rapid tests with high sensitivity and precision to be performed on a large scale and provide timely diagnosis. Furthermore, other tools must be available, and although they will not establish the diagnosis, will allow the professional to provide better clinical and epidemiological management that will help predict the worsening of the patient and possible admission to the ICU. Among these, levels of D-dimer, lymphocytes, ferritin, urea and creatinine. In this review, the usefulness and limitations of the different diagnostic methods for COVID-19 are evaluated, as well as the characteristics, pathophysiology and immune response to SARS-CoV-2, and some important preanalytical aspects that allow minimizing diagnostic errors as a consequence of incorrect procedures in the collection, transport and conservation of the sample, that allow the professional to yield accurate and reliable results. This article was completed based on original articles, reviews and clinical guidelines

Study on bioaerosol diffusion and deposition in a mobile BSL-4 laboratory based on air age analysis

Biosafety issues have aroused global concern, especially after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron strain of corona virus disease 2019 (COVID-19) caused incalculable human and property losses. Laboratory-acquired infections (LAIs) caused by improper operations or accidents are frequently reported. Research is urgently needed for a mobile biosafety level-4 (BSL-4) laboratory with a high risk for exposure. Deposition characteristics and the spatial distribution of bioaerosols under two typical cases were studied in this paper. Based on the age of air and simulation of airflow pattern, a detailed analysis of infection risk and the distribution of bioaerosols was conducted. The deposition characteristics of particles on different surfaces were analyzed based on particle tracking technology. The results showed that the removal rate of bioaerosols was lower in the space area of the laboratory from 1.6 m above the ground. The distribution of high-risk areas is affected by the coupling of equipment layout and pollution sources, mainly located downstream of the main airflow in the laboratory, and the particle concentration was eight times that of the low-risk areas. More than half of bioaerosol particles are deposited on laboratory equipment and walls. The number of particles deposited on the wall was the largest, accounting for 25.02% of the total. The unit area deposition ratio of the experimental table was the highest, which was 6.14 %/m2. The main deposition area of each surface was determined, which could be of guiding significance to the determination of the key disinfection location of the mobile BSL-4 laboratory. © 2023 Elsevier Ltd

Experience of using an adapted snorkel mask as personal protective equipment in the COVID-19 pandemic

Introduction: During the COVID-19 pandemic and the cases of shortages of personal protective equipment (PPE), the utilization of modified snorkel masks has been documented, seeking to provide respiratory and facial pro-tection against SARS-CoV-2 aerosols. However, there is no report of changes in vital signs that can occur with its use, along with the perception of its wear by health personnel. Method(s): A case series was performed. Equipment: Snorkel mask, 3D adapter, and antimicrobial filter. CO2 level, respiratory rate, oximetry, pulse, and blood pressure were monitored for one hour. During the time of use, activities related to patient care were simulated. At the end, the usage characteristics were evaluated through a survey. Result(s): 14 volunteers were included in the study. After one hour of conti-nuous use, the clinical parameters were predominantly normal. 85% of the participants preferred this modified snorkel mask instead of personal protective equipment established for COVID-19 (goggles, N95 mask and visor). Conclusion(s): The adapted snorkel mask could be an alternative to PPE equipment in situations of scarce resources. This is only considered within the framework of its acceptability by a group of health professionals, in addition to the few effects on the vital signs evaluated in this case series. Further objective evaluations of usability and effectiveness are required. Copyright © 2023 Universidad de Antioquia.

Dental biosafety from pediatric dentists' perception in times of COVID-19, Lima, 2020

Objective: To describe pediatric dentists' perceptions regarding dental biosafety in times of COVID-19 in Lima, 2020. Material(s) and Method(s): A qualitative, phenomenological and content-analysis study. In-depth semi-structured interviews were conducted with 18 pediatric dentists through the Zoom videoconferencing platform, following the guidelines described in a guide and after obtaining the pertinent virtual informed consent. ATLAS.ti software version 8.4 was used for data analysis, where all the verbatim files of each interview were uploaded. Result(s): Pediatric dentists perceived themselves to be professionally empowered with knowledge about biosafety measures. Moreover, they highlighted the mastery of various techniques such as mouthwash, use of personal protective equipment, control of aerosols, social distancing between patients and disinfection of environments, which are essential for patient safety. They also reported that biosafety regulations are somewhat confusing, unclear, and lack a pediatric approach. Conclusion(s): Pediatric dentists are strategic human resources for healthcare because they gained biosafety knowledge as part of their professional education and received training on new biosafety regulations in the context of the COVID-19 pandemic. It is important to standardize the criteria and approaches in the model of care for pediatric dentistry and guarantee the conditions for the sustainability of this professional practice. Copyright © La revista.

Laboratory Biosafety Intelligent Management System Design

The outbreak of the new crown pneumonia on a global scale has caused serious damage to every country, whether financial or human, and the death toll has also increased significantly. This enhances the importance of laboratory biosafety management, which is related to human life safety and should not be underestimated. In the past, biosafety has not received much attention, resulting in the biosafety management status of biosafety laboratories in my country is not optimistic. On the one hand, it is necessary to cope with reducing the number of people infected with pneumonia. On the other hand, there is an urgent need to match drugs against the new crown. Time is very short, and the number of infected people will increase rapidly according to time. Since viral nucleic acid testing is toxic, it has been reported in our country that many doctors have been infected with the new coronavirus, which has dealt a heavy blow to laboratory biosafety and the people of the country. Immediately afterwards, many medical universities were also exposed to lax safety management, lack of laboratory safety principles, and low safety factor for teachers and students. With the development of life safety and biotechnology, efficient implementation should strengthen research on biotechnology and management safety. The state also hopes that they can make rectifications. This also gives great trust to the management of biosafety laboratories in colleges and universities. I hope they can do their best. correct. © 2022 SPIE.

“Risk Management Can Actually Be Fun” - Using the Serious Cards for Biosafety Game to Stimulate Proper Discussions About Biosafety

As part of a Dutch Science Foundation project called T-TRIPP, the authors developed the serious game Cards for Biosafety. The aim of Cards for Biosafety is to let young biotechnology researchers learn more about biosafety. Analyses of workshops with researchers from the biotechnology domain as well as results of interviews with several biosafety officers clearly indicated the need for such a serious game with a focus on educational learning. Cards for Biosafety is a physical (also playable online on Tabletopia) round-based card game and playable with up to eight players. The game itself consists of scenario, risk and measure cards, and the task of the players is to choose risk and measure cards that fit the scenario explained by the facilitator at the beginning of each round. To test the efficiency of Cards for Biosafety as a learning tool, the authors conducted two online-workshops with twelve participants. The results of these sessions have not only shown that Cards for Biosafety is a well-designed game, but also a successful game to achieve the intended learning goal. In addition, the authors recognized that ‘fun’ is an important element in the game which leads to ‘learning’ in a very effective way. Future research should focus on the role of such positive states in serious games and their influence on learning outcomes. © 2022, Springer Nature Switzerland AG.

Addressing biohazards to food security in primary production

This review addresses ways to prepare for and to mitigate effects of biohazards on primary production of crops and livestock. These biohazards can be natural or intentional introductions of pathogens, and they can cause major economic damage to farmers, the agricultural industry, society, and international trade. Agroterrorism is the intentional introduction of animal or plant pathogens into agricultural production systems with the intention to cause socioeconomic harm and generate public fear. Although few acts of agroterrorism are reported, the threat of agroterrorism in Europe is real. New concerns about threats arise from the rapid advancements in biotechnology and emerging technologies. FORSA, an analytical framework for risk and vulnerability analysis, was used to review how to prepare for and mitigate the possible effects of natural or intentional biohazards in agricultural production. Analyzing the effects of a biohazard event involves multiple scientific disciplines. A comprehensive analysis of biohazards therefore requires a systems approach. The preparedness and ability to manage events are strengthened by bolstered farm biosecurity, increased monitoring and laboratory capacity, improved inter-agency communication and resource allocation. The focus of this review is on Europe, but the insights gained have worldwide applications. The analytical framework used here is compared to other frameworks. With climate change, Covid-19 and the war in Ukraine, the supply chains are challenged, and we foresee increasing food prices associated with social tensions. Our food supply chain becomes more fragile with more unknowns, thereby increasing the needs for risk and vulnerability analyses, of which FORSA is one example.

Design Development of Portable (Mini) Multi-function Incinerator for Dry Medical Waste Handling

Medical waste contains biohazard, such as dry medical waste from the Centre of Public Health Services (PUSKESMAS) should be burning out, especially in the pandemic of covid 19. One of the possible solution is burning the waste by using incinerator. Basic concept of incinerator is controlled high temperature combustion, thus it should be perfect condition to burnt out the hazardous waste. Heat energy that exposed while incinerator operated should having high potency to be used for other purposes such as water heater and carbonization process. This research aims to develop an incinerator which can be used not only as high temperature burner (as incinerator’s main function), but also for water heater system and carbonization process, in the same time. The incinerator designed as mini portable incinerator since it will be used in a center of public health services (PUSKESMAS). Both of hot water and charcoal produced while incinerator operation can be used for sanitation purposes in the PUSKESMAS itself. Combustion process temperatures, smoke quality, safety factor, and energy utilities are the parameters which were determined as incinerator performance. Some design improvement has been done to the original design by Pradipta and Agustina [1] in order to improve the incinerator performance. The latest design performance is showing that combustion temperature successfully increased up to 980 °C for combustion rate of 9 kg waste/hour. Utilization of heat energy produced by combustion process inside the chamber has been successfully produce 2-2,5 kg of good quality coconut shell charcoal and hot water of 83 °C at 6 lt/minute flow rate.

Biosafety in dentistry on the context of COVID-19

Objectives: To compare the biosafety protocols of nine Latin American countries, the changes in biosafety measures under the context of the COVID-19 pandemic, and their impact on dentistry. Methodology: A bibliographic search was carried out using the keywords "coronavirus", "dentistry", "biosecurity", "COVID-19", "pandemic", "dental care" and "protocols". Articles related to biosafety were searched through the COVID-19 category that were published between January and December 2020 in the databases SciELO, Redalyc, SCOPUS, the Regional Portal of the Virtual Health Library (VHL), official pages of the World Health Organization and ministries of health of Latin American countries. Conclusions: There is no great difference between the biosafety protocols of each country, except for some specific measures that are given according to their own context. It is obtained that the impact of COVID-19 in the economic and emotional sphere would be unfavorable.

PARTICIPATORY DEVELOPMENT OF HEALTH PROTOCOLS FOR THE RETURN TO CLASSROOM DURING THE COVID-19 PANDEMIC BY EDUCATIONAL SERVICES ASSISTANTS

In Brazil, the number of victims of the COVID-19 pandemic already exceeds 500 thousand. In this context, the government seeks safe alternatives for the return of economic, social, and educational activities. Many Brazilian municipalities are involved in the development and implementation of health and safety protocols for the return of classroom classes in public schools during the pandemic. Thus, this practice report aims to present and discuss the methodology used to create health and safety protocols for return to classroom classes, from the perspective of food handlers in the city of Andrados, MG. The development of the protocols took place during an Extension Course held with the participation of 105 assistants from educational services in the municipality (87.5% of the total), through construction participated. The work presents the process in detail and highlights the importance of multidisciplinary, collaborative work, in addition to professional appreciation.

SARS-CoV-2 and other pathogens in municipal wastewater, landfill leachate, and solid waste: A review about virus surveillance, infectivity, and inactivation.

This review discusses the techniques available for detecting and inactivating of pathogens in municipal wastewater, landfill leachate, and solid waste. In view of the current COVID-19 pandemic, SARS-CoV-2 is being given special attention, with a thorough examination of all possible transmission pathways linked to the selected waste matrices. Despite the lack of works focused on landfill leachate, a systematic review method, based on cluster analysis, allows to analyze the available papers devoted to sewage sludge and wastewater, allowing to focalize the work on technologies able to detect and treat pathogens. In this work, great attention is also devoted to infectivity and transmission mechanisms of SARS-CoV-2. Moreover, the literature analysis shows that sewage sludge and landfill leachate seem to have a remote chance to act as a virus transmission route (pollution-to-human transmission) due to improper collection and treatment of municipal wastewater and solid waste. However due to the incertitude about virus infectivity, these possibilities cannot be excluded and need further investigation. As a conclusion, this paper shows that additional research is required not only on the coronavirus-specific disinfection, but also the regular surveillance or monitoring of viral loads in sewage sludge, wastewater, and landfill leachate. The disinfection strategies need to be optimized in terms of dosage and potential adverse impacts like antimicrobial resistance, among many other factors. Finally, the presence of SARS-CoV-2 and other pathogenic microorganisms in sewage sludge, wastewater, and landfill leachate can hamper the possibility to ensure safe water and public health in economically marginalized countries and hinder the realization of the United Nations' sustainable development goals (SDGs).

The clinical practice of Pediatric Dentistry post-COVID-19: The current evidences.

The Severe Acute Respiratory Syndrome (SARS) caused by SARS-CoV-2 virus has quickly spread all over the world, directly affecting the dentistry practice. This study aimed to perform a literature review about the current evidences on biosafety practices and clinical recommendations regarding the return to the elective dental care in the practice of Pediatric dentistry. An electronic search was performed in PubMed, Scopus, Web of Science and Grey literature databases using the terms "Pediatric dentistry" and "COVID-19". Initially, 38 studies were retrieved. After title and abstract were read, it was identified that 22 studies referred specifically to children's dental practice. A total of 19 studies were included in this study. The COVID-19 pandemic will imply significant changes in the reorientation of dental practices, from biosafety issues to technical procedures. Greater rigor in the use of Personal Protective Equipment (PPE) may cause strangeness for children. Consequently, an improvement in the management of patient's behavior before and during the treatment and new approaches to perform the procedures will be demanded. Non-aerosol techniques and minimally invasive procedures will be preferable whenever possible. Professionals will need to be constantly updated based on what the scientific literature recommends. The moment is suitable for the use of preventive practice and minimally invasive techniques.

Religious Support as a Contribution to Face the Effects of Social Isolation in Mental Health During the Pandemic of COVID-19.

Coping with the COVID-19 pandemic has required measures to contain the contagion, including social isolation. However, this and other factors have caused mental health problems, both in patients and health professionals and in family members or asymptomatic population. Religious support can be an ally for this type of confrontation. In the case of the COVID-19 pandemic, spiritual/religious care has been restricted and insufficient. When accessible to patients and frontline professionals, they are offered by virtual means, almost always by recorded media and made available in bulk. This essay argues, based on references in the areas of psychology, psychoneuroimmunology, biosafety, and military, that the face-to-face and personalized relationship between religious leaders, patients, health professionals, family members, and faith communities is as essential as possible for the dignified treatment victims, referral to spiritual needs and resilience of society, in addition to contributing to the improvement of the immune response of all. Practical examples are cited in the areas of military chaplaincy and hospital civilian chaplaincy. The essay also proposes the adoption of protocols already published by WHO and other safety measures such as the use of robotics and the recruitment/training of mass chaplains. In addition to contributing to the improvement of COVID-19 pandemic coping processes, the study also contributes to improving the delivery of spiritual/religious care as an ally to physical and mental, individual, and collective health.

Proposal for detection of 2019-nCoV nucleic acid in clinical laboratories / 中华检验医学杂志

In December, the outbreak of a novel coronavirus (2019-nCoV) in Wuhan, China, has attracted extensive global attention. On January 20, 2020,the Chinese health authorities upgraded the coronavirus to a Class B infectious disease in the Law of the People's Republic of China on the Prevention and Treatment of Infectious Diseases, and considered it as Class A infectious diseases in disease control and prevention. On January 22, 2020, the 2019-nCoV nucleic acid detection test was listed as the diagnostic criteria in the "guidelines for diagnosis and treatment of pneumonia due to 2019-nCoV (Trial Version 2)" . Therefore, standardizing the operation process of the 2019-nCoV nucleic acid detection in clinical laboratories has become a top priority. It is of paramount importance to establish standard protocols for detection of the 2019-nCoV nucleic acids in clinical laboratories to improve the reliability of the results and ensure the biosafety of laboratory personnel.

Biosafety Consensus for 2019 Novel Coronavirus Pneumonia in Clinical Laboratory / 中华检验医学杂志

With the outbreak and spread of the 2019 Novel Coronavirus pneumonia, laboratory biosafety has become increasingly prominent. The Society of Laboratory Medicine of Chinese Medical Association formulates this guideline with reference to Chinese National Recommendations and relevant documents. From the perspectives of Microbiology, Epidemiology, Case Definition, Safety Principles, Personal Precaution, Specimen Collection, Specimen Transport, Specimen Handling, Analysis, Post-Analysis and Emergencies, this guideline gives recommendations on biosafety precaution and biosafety protection. We hope that it can be practically implemented and continuously improved to ensure laboratory safety.

The laboratory risk assessment and control testing 2019 novel coronavirus in biosafety class II laboratories / 中华检验医学杂志

The outbreak of 2019 Novel Coronavirus (2019-nCoV) has spread from Wuhan to the whole country. After the Spring Festival, workers will return to workplace and students will return to school. There is an increasing risk of 2019-nCoV cases being imported into provinces and cities. In order to promote the prevention and control of 2019-nCoV infection, reduce the risk of transmission in medical institutions, and ensure medical quality and medical safety, it is necessary to carry out the detection test of 2019-nCoV in biosafety class II laboratory. In order to achieve the goal of zero infection of the laboratory personnel, different preventive measures should be taken to assess the risk of the experimental activities.

Prevention and consideration for the biosafety of laboratory testing under epidemic condition / 中华检验医学杂志

Laboratory testing plays an important role in the diagnosis and treatment of patients with Novel Coronavirus pneumonia. However, the lack of understanding of the virus in the early stage led to great difficulties in biosafety protection for clinical laboratories. Based on the latest researches and findings about the virus, this paper provides some personal opinions on the biosafety prevention in clinical laboratorians under epidemic condition for the reference of laboratory workers.