The Two Sides of Cytopathology during the COVID-19 Health Emergency: Screening versus Diagnosis

Pisapia, Pasquale; Troncone, Giancarlo

doi:10.1159/000509958

Cited by 8 publications

(8 citation statements)

References 5 publications

(6 reference statements)

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“…Mediastinal lymph nodes showed viral infection at a high frequency, with RNA identification in almost 70% by RT-qPCR and 25% by RNA-ISH. An identical positivity rate by RT-qPCR was reported by Haslbauer et al [42]. Other organs of the thoracal cavity were affected at a lower frequency and with a lower viral load.…”

Section: Viral Mappingsupporting

confidence: 86%

Viral mapping in COVID-19 deceased in the Augsburg autopsy series of the first wave: A multiorgan and multimethodological approach

et al. 2021

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Background COVID-19 is only partly understood, and the level of evidence available in terms of pathophysiology, epidemiology, therapy, and long-term outcome remains limited. During the early phase of the pandemic, it was necessary to effectively investigate all aspects of this new disease. Autopsy can be a valuable procedure to investigate the internal organs with special techniques to obtain information on the disease, especially the distribution and type of organ involvement. Methods During the first wave of COVID-19 in Germany, autopsies of 19 deceased patients were performed. Besides gross examination, the organs were analyzed with standard histology and polymerase-chain-reaction for SARS-CoV-2. Polymerase chain reaction positive localizations were further analyzed with immunohistochemistry and RNA-in situ hybridization for SARS-CoV-2. Results Eighteen of 19 patients were found to have died due to COVID-19. Clinically relevant histological changes were only observed in the lungs. Diffuse alveolar damage in considerably different degrees was noted in 18 cases. Other organs, including the central nervous system, did not show specific micromorphological alterations. In terms of SARS-CoV-2 detection, the focus remains on the upper airways and lungs. This is true for both the number of positive samples and the viral load. A highly significant inverse correlation between the stage of diffuse alveolar damage and viral load was found on a case and a sample basis. Mediastinal lymph nodes and fat were also affected by the virus at high frequencies. By contrast, other organs rarely exhibited a viral infection. Moderate to strong correlations between the methods for detecting SARS-CoV-2 were observed for the lungs and for other organs. Conclusions The lung is the most affected organ in gross examination, histology and polymerase chain reaction. SARS-CoV-2 detection in other organs did not reveal relevant or specific histological changes. Moreover, we did not find CNS involvement.

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Section: Viral Mappingsupporting

confidence: 86%

Viral mapping in COVID-19 deceased in the Augsburg autopsy series of the first wave: A multiorgan and multimethodological approach

et al. 2021

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“…Reductions in both exfoliative and aspirative cytological samples contributed to the drastic decrease in the number of total processed specimens 8 . Similar observations were reported by de Pelsemaeker et al 15 The reduction in exfoliative cytological samples is associated with the significant decrease or suspension of screening programmes in many countries during the peak of the COVID‐19 pandemic and/or the reluctance of people to participate in screening programmes 33‐36 . As far as aspirative cytological samples are concerned, a major impact in the drastic reduction during the COVID‐19 healthcare emergency was associated with the decrease of the number of thyroid fine needle aspiration (FNA) specimens 8,37 .…”

Section: The Effect Of Covid‐19 On Cytopathology Diagnostic Activitysupporting

confidence: 59%

Juggling the COVID‐19 pandemic: A cytopathology point of view

et al. 2020

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Since its first identification in China at the end of 2019, severe acute respiratory syndrome coronavirus 2 has rapidly spread all over the world, becoming an international healthcare emergency. In the era of coronavirus disease‐2019 (COVID‐19), several aspects of normal life, including those related to the medical activities, have been radically changed. Extraordinary measures have been adopted by different nations to cope with the rapid diffusion of COVID‐19 all over the world. In hospitals, careful attention has been paid to manage infected patients with a possible detrimental effect for patients affected by other diseases. As with other medical fields, cytopathology laboratories have also drastically modified their activities to cope with the COVID‐19 healthcare emergency. Here, the main effects of COVID‐19 pandemic on the routine practice of cytopathology are summarised, focusing on the prioritisation policy adopted by cytopathologists worldwide.

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“…These data strongly support the role of cytology in the diagnostic management of high‐risk patients with cancer, even during this unprecedented health care emergency. 18 , 19 However, despite these results, the continued reduction of processed cytological samples in the post‐lockdown period, which is related to national health care system countermeasures and the persistent reluctance of patients to go to the hospital, represents a global health care issue and serves as an important reminder of the potential consequences that such national policy measures can have on individuals with cancer.…”

Section: Discussionmentioning

confidence: 99%

COVID‐19 pandemic impact on cytopathology practice in the post‐lockdown period: An international, multicenter study

Vigliar

Pisapia

Iacovo

et al. 2022

Cancer Cytopathology

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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.

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The Two Sides of Cytopathology during the COVID-19 Health Emergency: Screening versus Diagnosis

Cited by 8 publications

References 5 publications

Viral mapping in COVID-19 deceased in the Augsburg autopsy series of the first wave: A multiorgan and multimethodological approach

Viral mapping in COVID-19 deceased in the Augsburg autopsy series of the first wave: A multiorgan and multimethodological approach

Juggling the COVID‐19 pandemic: A cytopathology point of view

COVID‐19 pandemic impact on cytopathology practice in the post‐lockdown period: An international, multicenter study

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