Medical University of Silesia in Katowice, Katowice, Poland (Faculty of Medical Sciences in Zabrze, Department of Dental Materials, Chair of Prosthetics and Dental Materials).
Medical University of Silesia in Katowice, Katowice, Poland (Faculty of Medical Sciences in Zabrze, Department of Chemistry).
Med Pr. 2021 Apr 9;72(2):155-162. doi: 10.13075/mp.5893.01034. Epub 2020 Oct 22.
In order to mitigate the spread of COVID-19, in the early stages of the pandemic outbreak, postponing elective procedures was recommended all around the world. Outpatient care and dental care were limited to telephone advice and emergency services. Dental staff is particularly vulnerable to SARS-CoV-2 contraction, because of the inevitable contact with patients' body fluids during aerosol-generating procedures. The implementation of diagnostic tests among ambulatory patients could improve the occupational safety among outpatient care personnel. The aim of this review was to introduce information regarding COVID-19 diagnostics with a particular focus on the methods which can be utilized in an outpatient and dental care setting. An online PubMed database review of articles on COVID-19 diagnostics, published on February 12-May 15, 2020, was conducted. Reverse transcription polymerase chain reaction is the gold standard in COVID-19 diagnostics, which determines if a person has an active infection. Unfortunately, its utilization in outpatient care is limited. Serological enzyme-linked immunosorbent assays identify people who were infected, including those who have had an asymptomatic infection, but they do not give sufficient information about the acute infection. Rapid serological assays developed to facilitate testing outside of laboratories, especially in dental offices, are not recommended by the World Health Organization to be used outside research settings, and they should not constitute the basis for clinical decision-making because of frequent false-negative results which may consequently contribute to personnel infections. Out of all available COVID-19 diagnostic methods, rapid serological assays seemed to be a method of choice in outpatient medical care. Unfortunately, their results turned out to be unreliable. The best methods to ensure the occupational safety of medical staff and to avoid cross-infections in outpatient care facilities include a thorough epidemiological interview, temperature measurement to rule out patients with an active infection, and the implementation of strict infection control procedures. Med Pr. 2021;72(2):155-62.
为了减缓 COVID-19 的传播，在大流行爆发的早期，全世界都建议推迟选择性手术。门诊护理和牙科护理仅限于电话咨询和紧急服务。由于在产生气溶胶的过程中不可避免地会接触到患者的体液，牙科工作人员特别容易感染 SARS-CoV-2。对门诊患者进行诊断性检测可以提高门诊医护人员的职业安全性。本综述的目的是介绍有关 COVID-19 诊断的信息，特别关注可在门诊和牙科护理环境中使用的方法。对 2020 年 2 月 12 日至 5 月 15 日发表的有关 COVID-19 诊断的在线 PubMed 数据库文章进行了回顾。逆转录聚合酶链反应是 COVID-19 诊断的金标准，可确定一个人是否存在活动性感染。不幸的是，它在门诊护理中的应用受到限制。酶联免疫吸附测定可识别已感染者，包括无症状感染者，但无法提供有关急性感染的充分信息。为了便于在实验室外进行检测而开发的快速血清学检测方法，世界卫生组织不建议在研究环境之外使用，并且由于频繁出现假阴性结果，这些结果可能会导致人员感染，因此不应该作为临床决策的基础。在所有可用的 COVID-19 诊断方法中，快速血清学检测似乎是门诊医疗的首选方法。不幸的是，它们的结果被证明是不可靠的。确保医务人员职业安全并避免门诊设施中交叉感染的最佳方法包括进行彻底的流行病学访谈、测量体温以排除活动性感染的患者，以及实施严格的感染控制程序。Przegl Lek. 2021;72(2):155-62.
