Turkiye Klinikleri Journal of Medical Sciences

.: REVIEW
SARS-CoV-2 and Protection Methods in Histology and Cytology Workflow: Traditional Review
Histoloji ve Sitoloji İş Akışında SARS-CoV-2 ve Korunma Yöntemleri: Geleneksel Derleme
Yılmaz BAŞa, Havva Hande KESER ŞAHİNa
aDepartment of Pathology, Hitit University Faculty of Medicine, Çorum, TURKEY
Turkiye Klinikleri J Med Sci. 2021;41(3):335-45
doi: 10.5336/medsci.2021-83798
Article Language: EN
Full Text
ABSTRACT
 This study aimed to discuss the prevention methods and recommendations from severe acute respiratory syndrome-coronavirus2 (SARSCoV-2) during the course of pathology laboratory procedures, before macroscopic dissection and during cytological processes. In the light of the latest scientific data, possible virus viability was evaluated on all surfaces and biopsy samples in Hitit University Faculty of Medicine pathology laboratory. In order to continue the pathology and cytology workflow, virus persistence probabilities according to the size of the biopsies, 'intraluminal formaldehyde fixation' before luminal organs and especially bowel dissection, consideration prevention methods from contamination in the cytological and histological work process were determined and suggested. Cytological preparations should not be transported in the open after the smear process and should be transported in protective closed containers. Technical handling of cytology specimens should be performed in a Class II biosafety cabinet with appropriate personal protection equipment. In order to accelerate the drying of the smears, it should be avoided to dry by shaking them in the air or drying with the help of air blowing devices. Before the intraoperative consultation, as in the normal process, clinical and pathology correlation should be established and it should be learned whether the patient carries a risk or not. Given the evolving pathology landscape and the high-risk nature of SARS-CoV-2, a clear understanding of the new information necessary for protection methods and implementation in biopsy process has become increasingly important to help guide for pathology practice. The need to organize definite rules within 'clinic-laboratory procedures and principles' to prevent unnecessary risks and spreads of the virus and to keep safety in pathology laboratories at the highest level is clear. Healthcare workers must be vaccinated.

Keywords: SARS-CoV-2; histology; cytology; COVID-19; pandemic
ÖZET
 Bu çalışma, patoloji laboratuvarı işlemleri sırasında makroskobik diseksiyon öncesi ve sitolojik süreçler sırasında şiddetli akut solunum sendromu-koronavirüs-2'nin [severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)] önleme yöntemlerini ve önerilerini tartışmayı amaçlamıştır. En son bilimsel veriler ışığında, Hitit Üniversitesi Tıp Fakültesi patoloji laboratuvarında tüm yüzeylerde ve biyopsi örneklerinde olası virüs varlığı değerlendirildi. Patoloji ve sitoloji iş akışına devam etmek için biyopsilerin büyüklüğüne göre virüs kalıcılık olasılıkları, lümenli organların ve özellikle bağırsak diseksiyonu öncesi 'lümen içi formaldehit fiksasyonu', sitolojik ve histolojik çalışma sürecinde kontaminasyondan korunma yöntemleri belirlenerek önerildi. Sitolojik preparatlar yayma işleminden sonra açıkta taşınmamalı ve koroyucu kapalı kaplar içinde transfer edilmelidir. Sitoloji örneklerin teknik işlemleri uygun kişisel koruma ekipmanına sahip bir Class II biosafety cabinett'te çalışılmalıdır. Yaymaların kurumasını hızlandırmak için, elde tutup havada sallayarak kurutmaktan veya hava üfleyen cihazlar yardımı ile kurutmaktan kaçınılmalıdır. intraoperatif konsültasyon öncesinde normal süreçte olduğu gibi klinik ve patoloji korelasyonu mutlaka kurulmalı ve hastanın risk taşıyıp taşımadığı öğrenilmelidir. Gelişen patoloji ortamı ve SARS-CoV-2'nin yüksek riskli doğası göz önüne alındığında, biyopsi sürecindeki koruma yöntemleri ve uygulama için gerekli olan yeni bilgilerin net bir şekilde anlaşılması, patoloji uygulamasına rehberlik etmek için giderek daha önemli hâle gelmiştir. Virüsün gereksiz risklerini ve yayılmalarını önlemek ve patoloji laboratuvarlarında güvenliği en üst düzeyde tutmak için 'klinik-laboratuvar prosedür ve ilkeleri' içerisinde kesin kurallar düzenleme ihtiyacı açıktır. Sağlık çalışanları mutlaka aşılanmalıdır.

Anahtar Kelimeler: SARS-CoV-2; histoloji; sitoloji; COVID-19; pandemi
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