Cytopathology Practices in the COVID-19 Pandemic
Summary
During the COVID-19 pandemic, cytopathology laboratories worldwide adapted rapidly to ensure continuity of diagnostic services while protecting staff and patients. Traditional specimen sources such as fine-needle aspirates, exfoliative smears and bronchial brushings were triaged to prioritise high-yield cases, reducing unnecessary exposure and conserving reagents. Enhanced biosafety measures, including revised workflow layouts, dedicated “hot” benches for suspected or confirmed cases and use of closed-container transport systems, minimised aerosol generation. The sudden shift to telecytology enabled remote slide review and multidisciplinary discussions, leveraging digital imaging platforms to maintain diagnostic accuracy and trainee education. Cytopathology units also participated in external quality assessment schemes repurposed from molecular diagnostics, ensuring the fidelity of ancillary techniques such as cell block immunohistochemistry and molecular assays for viral detection. Globally, laboratories have shared protocols for specimen inactivation, fixative optimisation and personal protective equipment (PPE) allocation, reinforcing resilience against supply-chain disruptions. These collective efforts underline the integral role of cytopathology in guiding patient management during a respiratory pandemic and lay the groundwork for future outbreak preparedness.
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Cytopathology Practices in the COVID-19 Pandemic publication trend
The graph below shows the total number of articles in cytopathology practices in the covid-19 pandemic across all publications each year (not limited to Nature Index journals).
Technical terms
Fine-needle aspiration (FNA): A minimally invasive technique using a thin needle to extract cellular material for cytological assessment.
Telecytology: The digital transmission and remote interpretation of cytological images to support diagnosis and consultation.
External Quality Assurance Programme (EQAP): A structured system of inter-laboratory proficiency testing to monitor and improve diagnostic performance.
Biosafety level 2 (BSL-2): Laboratory containment practices and safety measures for handling moderate-risk biological agents to prevent exposure and environmental release.
References
- Proceedings of the Clinical Microbiology Open 2022—assessing clinical laboratory and industry responses to COVID-19 pandemic testing capacity challenges (part 1). Journal of Clinical Microbiology (2024).
- Mobile biosafety level (BSL) 2 laboratories deployment: Strengthening the diagnostic facilities in Pakistan with emerging public health challenges and the way forward. Journal of Biosafety and Biosecurity (2023).
- Monitoring the quality of SARS‐CoV‐2 virus detection in molecular diagnostic laboratories in the Eastern Mediterranean Region during the COVID‐19 pandemic. Influenza and Other Respiratory Viruses (2023).
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