Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India.
Indian J Pathol Microbiol. 2023 Oct-Dec;66(4):770-774. doi: 10.4103/ijpm.ijpm_173_22.
Corona Virus Disease-19 (COVID-19) disease which is still showing peaks and plateau with emerging new mutational viral variants has led to the modification of working of hospitals and medical institutes. Cytopathology laboratories geared up with the changing situation to cope up with not only the COVID-19 patients but also patients of other diseases, particularly oncology patients. It was also important to adopt changes in the cytopathology residency program so as to cope up with the changing scenario.
The present study was conducted to study the various measures adopted and the changes made in the cytopathology laboratory during COVID-19 infection in a resource-limited setting while catering to a large population of COVID-19-positive patients in the north Himalayan region of India. It was also intended to study the methods adopted for effective cytopathology residency training during corona times.
The study was conducted from March 2020 to December 2021 in the cytopathology lab, and all the samples were analyzed and compared with the samples received in pre-corona times from March 2018 to December 2019. The different methods adopted during corona times for effective cytopathology residency training were also analyzed.
The total number of samples received in the cytopathology laboratory in pre-corona times from March 2018 to December 2019 were 6822, and samples received from March 2020 to December 2021 were 6567 with decrease of 1.9% of cases. There was increase in 17.4% for the samples of the respiratory tract received in the lab with an increase in cases of infections including aspergillosis, mucormycosis, and tuberculosis. There was 10.3% increase in cytological diagnosis of malignant cases during corona times. Use of 90% alcohol for fixation rather than air drying of smears, avoiding of pneumatic tubes, judicious use of personal protective equipment (PPE) kits along with access to the digital cytology slide database were included in the changes made in the lab.
There was a marginal decrease in cytopathological diagnosis during COVID-19 with substantial increase in the malignancy rate of 10.3% in cytological diagnosis of different organs. Diagnosis of mucormycosis, aspergillosis, and tuberculosis infections of respiratory tract cytology increased during this period. Judicious use of limited available resources led not only to smooth functioning of the cytopathology lab but also prevented any infection in the working health personals. Newer online resources were explored and modified for continuous training of the cytopathology residents. Emotional support with effective communication was the key to alleviate any psychological stress among all health professionals in the cytopathology laboratory.
新冠病毒疾病（COVID-19）仍处于高峰期和平台期，新的病毒变异不断出现，这导致医院和医疗机构的工作方式发生了改变。细胞病理学实验室也根据不断变化的情况进行了调整，不仅要应对 COVID-19 患者，还要应对其他疾病的患者，特别是肿瘤患者。改变细胞病理学住院医师培训计划也很重要，以应对不断变化的局面。
本研究旨在探讨在资源有限的情况下，细胞病理学实验室在 COVID-19 感染期间采取的各种措施和变化，同时为印度喜马拉雅北部地区大量 COVID-19 阳性患者提供服务。本研究还旨在探讨在新冠疫情期间采用有效的细胞病理学住院医师培训方法。
本研究于 2020 年 3 月至 2021 年 12 月在细胞病理学实验室进行，对所有样本进行了分析，并与 2018 年 3 月至 2019 年 12 月期间收到的 COVID-19 前样本进行了比较。还分析了在新冠疫情期间为有效细胞病理学住院医师培训而采用的不同方法。
在 COVID-19 前的 2018 年 3 月至 2019 年 12 月期间，细胞病理学实验室收到的样本总数为 6822 例，而 2020 年 3 月至 2021 年 12 月期间收到的样本为 6567 例，病例减少了 1.9%。实验室收到的呼吸道样本增加了 17.4%，包括曲霉病、毛霉菌病和结核病感染病例增加。COVID-19 期间，恶性病例的细胞学诊断增加了 10.3%。实验室的变化包括使用 90%酒精固定而不是空气干燥涂片、避免使用气动管、明智使用个人防护设备 (PPE) 套件以及访问数字细胞学幻灯片数据库。
COVID-19 期间细胞病理学诊断略有减少，但不同器官的恶性肿瘤诊断率显著增加了 10.3%。在此期间，呼吸道细胞学诊断的毛霉菌病、曲霉病和结核病感染增加。明智地利用有限的可用资源不仅使细胞病理学实验室顺利运作，而且还防止了工作人员的任何感染。还探索并修改了新的在线资源，为细胞病理学住院医师提供持续培训。与所有细胞病理学实验室的卫生专业人员进行有效的沟通，提供情感支持是减轻他们任何心理压力的关键。
