Subject(s)
COVID-19 , Child Health Services/standards , Disease Transmission, Infectious/prevention & control , Infection Control , Respiratory Function Tests , Respiratory Tract Diseases/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Child , Child Health , Humans , Infection Control/instrumentation , Infection Control/methods , Infection Control/organization & administration , Quality Improvement , Respiratory Function Tests/adverse effects , Respiratory Function Tests/methods , Respiratory Function Tests/standards , Risk Assessment , SARS-CoV-2 , Safety Management/trendsABSTRACT
BACKGROUND: As the Coronavirus disease 2019 (COVID-19) is spreading worldwide, countries are dealing with different phases of the pandemic. Lately, scientific evidence has been growing about the measures for reopening respiratory outpatient services during the COVID-19 pandemic. We aim to summarize the key differences and similarities among recommendations by different national and international organizations. METHODS: We searched on Google and Pubmed for recently published National and International Recommendations/Guidelines/Position Papers from professional organizations and societies, offering a guidance to physicians on how to safely perform pulmonary function testing during COVID-19 pandemic. We also searched for spirometry manufacturers' operational indications. RESULTS: Indications on spirometry were released by the Chinese Task force, the American Thoracic Society, the European Respiratory Society, the Thoracic Society of Australia and New Zealand, the Société de Pneumologie de Langue Française, the Spanish Societies (Sociedad Espanola de Neumologia y Cirugia Toracica, Sociedad Espanola de Alergologia e Inmunologia Clinica, Asociacion de Especialistas en Enfermeria del trabajo, Asociacion de Enfermeria Comunitaria), the Sociedade Portuguesa de Pneumologia, the British Thoracic Society/Association for Respiratory Technology & Physiology, the Irish Thoracic Society, the Sociedad Uruguaya de Neumologia, the Italian Thoracic Society and the Italian Respiratory Society, Cleveland Clinic and Nebraska Medical Center. Detailed technical recommendations were found on manufacturers' websites. We found several similarities across available guidelines for safely resuming pulmonary function services, as well as differences in criteria for selecting eligible patients for which spirometry is deemed essential and advice which was not homogenous on room ventilation precautions. CONCLUSIONS: This study shows a synthesis of national/international guidelines allowing practicing physicians to adapt and shape the way to organize their outpatient services locally. There is generally good agreement on the importance of limiting pulmonary function testing to selected cases only. However, significant differences concerning the subsets of candidate patients, as well as on the management of adequate room ventilation, were observed.
Subject(s)
COVID-19/physiopathology , Manufacturing Industry/organization & administration , Respiratory Function Tests/methods , Spirometry/methods , Ambulatory Care Facilities/organization & administration , Ambulatory Care Facilities/standards , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Clinical Decision-Making/ethics , Consensus , Disease Outbreaks , Equipment Design/standards , Equipment and Supplies Utilization/standards , Guidelines as Topic/standards , Humans , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Manufacturing Industry/statistics & numerical data , Pandemics , Physicians , Respiratory Function Tests/standards , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Safety , Spirometry/standardsSubject(s)
Aftercare/standards , Betacoronavirus/pathogenicity , Bronchiectasis/diagnosis , Coronavirus Infections/complications , Pneumonia, Viral/complications , Pulmonary Fibrosis/diagnosis , Age Factors , Aged , Betacoronavirus/isolation & purification , Bronchiectasis/epidemiology , Bronchiectasis/etiology , Bronchiectasis/prevention & control , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Coronavirus Infections/virology , Female , Glucocorticoids/therapeutic use , Humans , Incidence , Lung/diagnostic imaging , Male , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Practice Guidelines as Topic , Pulmonary Fibrosis/epidemiology , Pulmonary Fibrosis/etiology , Pulmonary Fibrosis/prevention & control , Radiography, Thoracic/standards , Respiratory Function Tests/standards , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Tomography, X-Ray Computed/standardsABSTRACT
BACKGROUND: Effective prevention and control strategies are mandatory to prevent SARS-CoV-2 infection. MAIN TEXT: The Italian Pediatric Respiratory Society promotes a series of new recommendations that should be followed in pulmonary function testing laboratories during the COVID-19 pandemic. CONCLUSION: Pulmonary function testing should be performed in children with chronic lung disease only if it is needed to guide management and limited to the necessary tests, namely spirometry. When performed, strict infection control measures should be followed due to the potential risk of transmitting SARS-CoV-2.
Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Practice Guidelines as Topic , Societies, Medical , COVID-19 , Child , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Global Health , Humans , Italy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Respiratory Function Tests/standards , SARS-CoV-2ABSTRACT
Coronavirus disease 2019 (COVID-19) is transmitted mainly by respiratory droplets and close contact, probably by aerosol. Pulmonary function testing procedures have been associated with an increasing risk of COVID-19 transmission among patients/subjects and medical staffs. Effective prevention and control strategies must be compulsorily implemented to prevent nosocomial infection. This recommendation is intended to be followed by healthcare workers (HCWs) of pulmonary function testing laboratory when COVID-19 is in epidemic. Based on the features of pulmonary function testing, precaution principles and considerations are developed in three aspects of management for HCWs, operating procedure, environment and equipment. Indications of pulmonary function testing should be followed strictly. It is strongly recommended to suspend the test for the confirmed or suspected cases of COVID-19 during the contagious stage, and to postpone the test for other patients if it is not imperative. Medical personnel should mandatorily adhere to the standard stratification of precaution measures. Patients/Subjects should be isolated in a separate area for testing. Disposable in-line filters must be used during pulmonary function testing. Cleaning and disinfection procedures for environment and equipment in pulmonary function testing laboratory should be paid more attention.