Bioseguridad en los laboratorios de patología; pandemia COVID-19. Revisión narrativa

Palabras clave: Bioseguridad, COVID-19, Patología, Laboratorio, SARS-CoV-2.

Resumen

La Organización Mundial de la Salud clasifica en su manual de bioseguridad de laboratorio los agentes infecciosos en 4 grupos de riesgo que van desde el nivel 1 al 4, estos niveles proporcionan una serie de procedimientos para la protección del personal del laboratorio. Luego de la evaluación de riesgos, el SARS-CoV-2 es un virus patógeno con alta tasa de mortalidad y un problema para la salud pública, por lo que se ha clasificado en el grupo de riesgo nivel 3. Las actividades de patología quirúrgica y citología propias de los laboratorios de anatomía patológica se ejecutan bajo un nivel de bioseguridad 2, debido a la clasificación del SARS-CoV-2 dentro del grupo de riesgo 3, se hace necesario reforzar las medidas de seguridad para proteger al personal, estos laboratorios juegan un papel importante en el diagnóstico histopatológico aportando información sobre la fisiopatología de la enfermedad y los mecanismos que conducen a la muerte de los pacientes; lo que permitirá mejorar el tratamiento de la enfermedad y diseñar políticas de salud pública efectivas. Esta revisión, describe las medidas de bioseguridad que deben implementarse en los laboratorios de anatomía patológica durante la pandemia actual de COVID-19.

Citas

Zhiming Y. Current status and future challenges of high-level biosafety laboratories in China. J Biosaf Biosecurity [Internet]. 2019;1(2):123-7. Disponible en: http://www.sciencedirect.com/science/article/pii/S2588933819300391 DOI: 10.1016/j.jobb.2019.09.005 PMID 32501434 PMCID PMC7148665 Google Académico Microsoft Académico

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med [Internet]. febrero de 2020;382(8):727-33. Disponible en: https://www.nejm.org/doi/10.1056/NEJMoa2001017?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed DOI: 10.1056/NEJMoa2001017 PMID 31978945 PMCID PMC7092803 Google Académico Microsoft Académico

Cuartas DE, Arango-Londoño D, Guzmán-Escarria G, Muñoz E, Caicedo D, Ortega D, et al. Análisis espacio-temporal del SARS-COV-2 en Cali, Colombia. Rev Salud Pública [Internet]. 2020;22(2):e286431. Disponible en: https://revistas.unal.edu.co/index.php/revsaludpublica/article/view/86431 DOI: 10.15446/rsap.v22n2.86431 SciELO Google Académico Microsoft Académico

Biscayart C, Angeleri P, Lloveras S, Chaves T do SS, Schlagenhauf P, Rodríguez-Morales AJ. The next big threat to global health? 2019 novel coronavirus (2019-nCoV): What advice can we give to travellers? - Interim recommendations January 2020, from the Latin-American society for Travel Medicine. Travel Med Infect Dis [Internet]. 2020;33:101567. Disponible en: http://www.sciencedirect.com/science/article/pii/S147789392030017X DOI: 10.1016/j.tmaid.2020.101567 PMID 32006657 PMCID PMC7128745 Google Académico Microsoft Académico

León-Gómez J. Implicaciones hepáticas en la pandemia por COVID-19. Rev Colomb Gastroenterol [Internet]. 2020;35(Suppl 1):30-6. Disponible en: https://revistagastrocol.com/index.php/rcg/article/view/535 DOI: 10.22516/25007440.535 SciELO Google Académico Microsoft Académico

Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Invest Radiol [Internet]. 2020;55(6):327-31. Disponible en: https://journals.lww.com/investigativeradiology/Fulltext/2020/06000/The_Clinical_and_Chest_CT_Features_Associated_With.1.aspx DOI: 10.1097/RLI.0000000000000672 PMID 32118615 PMCID PMC7147273 Google Académico Microsoft Académico

Ma H, Zhu J, Liu J, Zhang X, Liu Y, Yang Q. Hospital biosecurity capacitation: analysis and recommendations for the prevention and control of COVID-19. J Biosaf Biosecurity [Internet]. 2020;2(1):5-9. Disponible en: http://www.sciencedirect.com/science/article/pii/S2588933820300078 DOI: 10.1016/j.jobb.2020.05.001 PMID 32835179 PMCID PMC725074 Google Académico Microsoft Académico

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet [Internet]. 15 de febrero de 2020;395(10223):497-506. Disponible en: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext DOI: 10.1016/S0140-6736(20)30183-5 PMID 31986264 PMCID PMC7159299 Google Académico Microsoft Académico

Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis [Internet]. 1 de mayo de 2020;94:91-5. Disponible en: https://www.ijidonline.com/article/S1201-9712(20)30136-3/fulltext DOI: 10.1016/j.ijid.2020.03.017 PMID 32173574 PMCID PMC7194638 Google Académico Microsoft Académico

Millán-Oñate J, Rodriguez-Morales AJ, Camacho-Moreno G, Mendoza-Ramírez H, Rodríguez-Sabogal IA, Álvarez-Moreno C. A new emerging zoonotic virus of concern: the 2019 novel Coronavirus (SARS CoV-2). Infectio [Internet]. 2020;24(3):187-92. Disponible en: http://www.revistainfectio.org/index.php/infectio/article/view/848 DOI: 10.22354/in.v24i3.848 SciELO Google Académico Microsoft Académico

Baharoon S, Memish ZA. MERS-CoV as an emerging respiratory illness: A review of prevention methods. Travel Med Infect Dis [Internet]. 2019;32:101520. Disponible en: http://www.sciencedirect.com/science/article/pii/S1477893919302236 DOI: 10.1016/j.tmaid.2019.101520 PMID 31730910 PMCID PMC7110694 Google Académico Microsoft Académico

Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun [Internet]. 2020;109:102433. Disponible en: http://www.sciencedirect.com/science/article/pii/S0896841120300469 DOI: 10.1016/j.jaut.2020.102433 PMID 32113704 PMCID PMC7127067 Google Académico Microsoft Académico

Li L, Huang T, Wang Y, Wang Z, Liang Y, Huang T, et al. 2019 novel coronavirus patients’ clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol [Internet]. 2020; [Publicación en avance] Disponible en: https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.25757 DOI: 10.1002/jmv.25757 PMID 32162702 PMCID PMC7228329 Google Académico Microsoft Académico

Jin Y, Yang H, Ji W, Wu W, Chen S, Zhang W, et al. Virology, epidemiology, pathogenesis, and control of COVID-19. Viruses [Internet]. 27 de marzo de 2020;12(4):372. Disponible en: https://www.mdpi.com/1999-4915/12/4/372 DOI: 10.3390/v12040372 PMID 32230900 PMCID PMC7232198 Google Académico Microsoft Académico

Kelvin AA, Halperin S. COVID-19 in children: the link in the transmission chain. Lancet Infect Dis [Internet]. 1 de junio de 2020;20(6):633-4. Disponible en: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30236-X/fulltext DOI: 10.1016/S1473-3099(20)30236-X PMID 32220651 PMCID PMC7156154 Google Académico Microsoft Académico

World Health Organization. Clinical management of severe acute respiratory infection (‎‎SARI)‎‎ when COVID-19 disease is suspected: interim guidance, 13 March 2020 [Internet]. Geneva-Geneva: World Health Organization; 2020. Disponible en: https://apps.who.int/iris/handle/10665/331446

Gudbjartsson DF, Helgason A, Jonsson H, Magnusson OT, Melsted P, Norddahl GL, et al. Spread of SARS-CoV-2 in the Icelandic Population. N Engl J Med [Internet]. 14 de abril de 2020;382(24):2302-15. Disponible en: https://doi.org/10.1056/NEJMoa2006100 DOI: 10.1056/NEJMoa2006100 PMID 32289214 PMCID: PMC7175425 Google Académico Microsoft Académico

Organización Mundial de la Salud. Novel Coronavirus. enero de 2020 [citado 17 de junio de 2020]; Disponible en: https://www.who.int/indonesia/news/novel-coronavirus

World Health Organization. Coronavirus disease 2019 (COVID-19): situation report, 38 [Internet]. Geneva-Geneva: World Health Organization; 2020. Disponible en: https://apps.who.int/iris/handle/10665/331226

World Health Organization. Coronavirus disease (‎‎COVID-19)‎‎: situation report, 147 [Internet]. Geneva-Geneva: World Health Organization; 2020. Disponible en: https://apps.who.int/iris/handle/10665/332550

Yu Y, Bu F, Zhou H, Wang Y, Cui J, Wang X, et al. Biosafety materials: an emerging new research direction of materials science from the COVID-19 outbreak. Mater Chem Front [Internet]. 2020;4(7):1930-53. Disponible en: http://dx.doi.org/10.1039/D0QM00255K DOI: 10.1039/D0QM00255K Google Académico Microsoft Académico

Artika IM, Ma’roef CN. Current Laboratory Biosecurity for Handling Pathogenic Viruses. Am J Biochem Biotechnol [Internet]. 6 de abril de 2018;14(2):108-16. Disponible en: https://thescipub.com/abstract/ajbbsp.2018.108.116 DOI: 10.3844/ajbbsp.2018.108.116 Google Académico Microsoft Académico

Ahmad T, Haroon, Dhama K, Sharun K, Khan FM, Ahmed I, et al. Biosafety and biosecurity approaches to restrain/contain and counter SARS-CoV-2/COVID-19 pandemic: a rapid-review. Turkish J Biol [Internet]. 2020;44(3):132-45. Disponible en: https://journals.tubitak.gov.tr/biology/issues/biy-20-44-si-1/biy-44-si-1-2-2005-63.pdf DOI: 10.3906/biy-2005-63 PMID 32595350 PMCID PMC7314504 Google Académico Microsoft Académico

Zhou D, Song H, Wang J, Li Z, Xu S, Ji X, et al. Biosafety and biosecurity. J Biosaf Biosecurity [Internet]. 2019;1(1):15-8. Disponible en: http://www.sciencedirect.com/science/article/pii/S2588933818300189 DOI: 10.1016/j.jobb.2019.01.001 PMID 32501430 PMCID PMC7148603 Google Académico Microsoft Académico

World Health Organization. Laboratory biosafety guidance related to coronavirus disease (COVID-19) [Internet]. 2020 [citado 17 de junio de 2020]. Disponible en: https://www.who.int/publications/i/item/laboratory-biosafety-guidance-related-to-coronavirus-disease-(covid-19)

Ağalar C, Öztürk Engin D. Protective measures for COVID-19 for healthcare providers and laboratory personnel. Turkish J Med Sci [Internet]. abril de 2020;50(SI-1):578-84. Disponible en: https://journals.tubitak.gov.tr/medical/issues/sag-20-50-si-1/sag-50-si-1-14-2004-132.pdf DOI: 10.3906/sag-2004-132 PMID 32299205 PMCID: PMC7195977 Google Académico Microsoft Académico

Tan SS, Yan B, Saw S, Lee CK, Chong AT, Jureen R, et al. Practical laboratory considerations amidst the COVID-19 outbreak: early experience from Singapore. J Clin Pathol [Internet]. 20 de marzo de 2020;206563. Disponible en: http://jcp.bmj.com/content/early/2020/06/01/jclinpath-2020-206563.abstract DOI: 10.1136/jclinpath-2020-206563 PMID 32198190 Google Académico Microsoft Académico

Organización Mundial de la Salud. Manual de bioseguridad en el laboratorio [Internet]. 3.a ed. Malta: Minimum graphics; 2005. 223 p. Disponible en: https://www.who.int/topics/medical_waste/manual_bioseguridad_laboratorio.pdf

Barbareschi M, Ascoli V, Bonoldi E, Cavazza A, Colombari R, Cozzi I, et al. Biosafety in surgical pathology in the era of SARS-Cov2 pandemia. A statement of the Italian Society of Surgical Pathology and Cytology. Pathologica [Internet]. 1 de abril de 2020;112(2):59-63. Disponible en: https://doi.org/10.32074/1591-951X-14-20 DOI: 10.32074/1591-951X-14-20 PMID 32324726 Google Académico Microsoft Académico

Miller JM, Astles R, Baszler T, Chapin K, Carey R, Garcia L, et al. Guidelines for safe work practices in human and animal medical diagnostic laboratories. Recommendations of a CDC-convened, Biosafety Blue Ribbon Panel. MMWR Suppl. enero de 2012;61(1):1-102. Disponible en: https://www.cdc.gov/mmwr/pdf/other/su6101.pdf PMID 22217667 Google Académico Microsoft Académico

Pambuccian SE. The COVID-19 pandemic: implications for the cytology laboratory. J Am Soc Cytopathol [Internet]. 2020;9(3):202-11. Disponible en: http://www.sciencedirect.com/science/article/pii/S2213294520300454 DOI: 10.1016/j.jasc.2020.03.001 PMID 32284276 PMCID PMC7104051 Google Académico Microsoft Académico

Iwen PC, Stiles KL, Pentella MA. Safety Considerations in the Laboratory Testing of Specimens Suspected or Known to Contain the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Am J Clin Pathol [Internet]. 15 de abril de 2020;153(5):567-70. Disponible en: https://academic.oup.com/ajcp/article/153/5/567/5810006 DOI: 10.1093/ajcp/aqaa047 PMID 32190890 PMCID PMC7184496 Google Académico Microsoft Académico

Center for Disease Control and Prevention. Interim Guidelines for Biosafety and COVID-19 [Internet]. 2020 [citado 17 de junio de 2020]. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/lab/lab-biosafety-guidelines.html

Henwood AF. Coronavirus disinfection in histopathology. J Histotechnol [Internet]. 2 de abril de 2020;43(2):102-4. Disponible en: https://www.tandfonline.com/doi/full/10.1080/01478885.2020.1734718 DOI: 10.1080/01478885.2020.1734718 PMID 32116147 Google Académico Microsoft Académico

Center for Disease Control and Prevention. Frequently Asked Questions about Coronavirus (COVID-19) for Laboratories [Internet]. 2020 [citado 17 de junio de 2020]. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/lab/faqs.html

Organización Mundial de la Salud. Infection prevention and control during halth care when novel coronavirus (nCOV) infection is suspected [Internet]. 2020 [citado 17 de junio de 2020]. Disponible en: https://www.who.int/publications/i/item/infection-prevention-and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-is-suspected-20200125

Rossi ED, Fadda G, Mule A, Zannoni GF, Rindi G. Cytologic and histologic samples from patients infected by the novel coronavirus 2019 SARS-CoV-2: An Italian institutional experience focusing on biosafety procedures. Cancer Cytopathol [Internet]. 1 de mayo de 2020;128(5):317-20. Disponible en: https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncy.22281 DOI: 10.1002/cncy.22281 PMID 32259373 PMCID PMC7262363 Google Académico Microsoft Académico

Chen CC, Chi CY. Biosafety in the preparation and processing of cytology specimens with potential coronavirus (COVID-19) infection: Perspectives from Taiwan. Cancer Cytopathol [Internet]. 1 de mayo de 2020;128(5):309-16. Disponible en: https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncy.22280 DOI: 10.1002/cncy.22280 PMID 32259402 PMCID PMC7262216 Google Académico Microsoft Académico

Rossi ED, Pantanowitz L. International perspectives: Impact of the COVID-19 pandemic on cytology. Cancer Cytopathol [Internet]. 1 de mayo de 2020;128(5):307-8. Disponible en: https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncy.22275 DOI: 10.1002/cncy.22275 PMID 32259387 PMCID: PMC7262335 Google Académico Microsoft Académico

Hanley B, Lucas SB, Youd E, Swift B, Osborn M. Autopsy in suspected COVID-19 cases. J Clin Pathol [Internet]. 1 de mayo de 2020;73(5):239-242. Disponible en: http://jcp.bmj.com/content/73/5/239.abstract DOI: 10.1136/jclinpath-2020-206522 PMID 32198191 Google Académico Microsoft Académico

Finegan O, Fonseca S, Guyomarc’h P, Morcillo Mendez MD, Rodriguez Gonzalez J, Tidball-Binz M, et al. International Committee of the Red Cross (ICRC): General guidance for the management of the dead related to COVID-19. Forensic Sci Int Synerg [Internet]. 2020;2:129-37. Disponible en: http://www.sciencedirect.com/science/article/pii/S2589871X20300309 DOI: 10.1016/j.fsisyn.2020.03.007 PMID 32412013 PMCID PMC7148714 Google Académico Microsoft Académico

Osborn M, Lucas S, Stewart R, Swift B, Youd E. Briefing on COVID-19. Autopsy practice relating to possible cases of COVID-19 (2019-nCov, novel coronavirus from China 2019/2020 [Internet]. 2020 [citado 17 de junio de 2020]. Disponible en: https://www.rcpath.org/uploads/assets/d5e28baf-5789-4b0f-acecfe370eee6223/fe8fa85a-f004-4a0c-81ee4b2b9cd12cbf/Briefing-on-COVID-19-autopsy-Feb-2020.pdf

Fineschi V, Aprile A, Aquila I, Arcangeli M, Asmundo A, Bacci M, et al. Management of the corpse with suspect, probable or confirmed COVID-19 respiratory infection-Italian interim recommendations for personnel potentially exposed to material from corpses, including body fluids, in morgue structures and during autopsy practi. Pathologica [Internet]. 1 de junio de 2020;112(2):64-77. Disponible en: https://www.pathologica.it/article/view/101 DOI: 10.32074/1591-951X-13-20 PMID 32324727 Google Académico Microsoft Académico

Center for Disease Control and Prevention. COVID-19 Guidance Postmortem Specimens [Internet]. 2020 [citado 17 de junio de 2020]. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-postmortem-specimens.html

Society of Pathological Doctors, Chinese Medical Doctors Association, Chinese Society of Pathology, Chinese Medical Association. [Provisional guidelines on autopsy practice for deaths associated with COVID-19]. Zhonghua bing li xue za zhi [Internet]. mayo de 2020;49(5):406-10. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32153166/ DOI: 10.3760/cma.j.cn112151-20200309-00184 PMID 32153166 Google Académico Microsoft Académico

Aquila I, Sacco MA, Abenavoli L, Malara N, Arena V, Grassi S, et al. Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic: Review of the Literature and Proposal for Safe Autopsy Practice. Arch Pathol Lab Med [Internet]. 8 de mayo de 2020;144(9):1048-56. Disponible en: https://doi.org/10.5858/arpa.2020-0165-SA DOI: 10.5858/arpa.2020-0165-SA PMID 32383963 Google Académico

Xue Y, Lai L, Liu C, Niu Y, Zhao J. Perspectives on the death investigation during the COVID-19 pandemic. Forensic Sci Int Synerg [Internet]. 2020;2:126-8. Disponible en: http://www.sciencedirect.com/science/article/pii/S2589871X20300334 DOI: 10.1016/j.fsisyn.2020.04.001 PMID 32412012 PMCID PMC7144508 Google Académico Microsoft Académico

Farkas CB, Petrétei D, Babinszky G, Dudás G, Szabó G, Bognár C, et al. [Role of duties related to COVID-19 suspected, probable and confirmed fatality cases]. Orv Hetil [Internet]. 2020;161(17):713-22. Disponible en: https://akjournals.com/view/journals/650/161/17/article-p713.xml DOI: 10.1556/650.2020.31818 PMID 32324985 Google Académico Microsoft Académico

Bañon-Gonzalez R, Carnicero-Caceres S, Suarez-Mier MP, Diaz FJ. Autopsies of suspected SARS-CoV-2 cases. Spanish J Leg Med [Internet]. julio de 2020;46(3):93-100. Disponible en: https://www.elsevier.es/en-revista-spanish-journal-legal-medicine-446-avance-resumen-autopsies-suspected-sars-cov-2-cases-S2445424920300200 DOI: 10.1016/j.remle.2020.05.002 PMCID PMC7363415 Google Académico Microsoft Académico

Lacy JM, Brooks EG, Akers J, Armstrong D, Decker L, Gonzalez A, et al. COVID-19: Postmortem Diagnostic and Biosafety Considerations. Am J Forensic Med Pathol [Internet]. 2020;41(3):143-51. Disponible en: https://journals.lww.com/amjforensicmedicine/Fulltext/2020/09000/COVID_19__Postmortem_Diagnostic_and_Biosafety.1.aspx DOI: 10.1097/PAF.0000000000000567 PMID 32379077 PMCID: PMC7202125 Google Académico Microsoft Académico

Organización Panamericana de la Salud. Manejo de cadáveres en el contexto del nuevo coronavirus (COVID-19). Recomendaciones provisionales, 7 de abril de 2020 [Internet]. 2020 [citado 17 de junio de 2020]. Disponible en: https://www.paho.org/es/documentos/manejo-cadaveres-contexto-nuevo-coronavirus-covid-19

Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 Autopsies, Oklahoma, USA. Am J Clin Pathol [Internet]. 5 de mayo de 2020;153(6):725-33. Disponible en: https://academic.oup.com/ajcp/article/153/6/725/5818922 DOI: 10.1093/ajcp/aqaa062 PMID 32275742 PMCID PMC7184436 Google Académico Microsoft Académico

Barbareschi M, Facchetti F, Fraggetta F, Sapino A. What are the priorities of pathologists’ activities during COVID-19 emergency? Pathologica [Internet]. 1 de junio de 2020;112(2):57-8. Disponible en: https://www.pathologica.it/article/view/102 DOI: 10.32074/1591-951X-15-20 PMID 32324728 Google Académico Microsoft Académico

Wang X. Enhancing the National Biosecurity System in China amidst COVID-19 Epidemic. J Biosaf Biosecurity [Internet]. 2020;2(1):3-4. Disponible en: http://www.sciencedirect.com/science/article/pii/S2588933820300054 DOI: 10.1016/j.jobb.2020.03.002 PMID 32313877 PMCID PMC7164852 Google Académico Microsoft Académico

Publicado
2020-10-05
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1.
Vásquez Bonilla WO, Silva Cárcamo H. Bioseguridad en los laboratorios de patología; pandemia COVID-19. Revisión narrativa. Kasmera [Internet]. 5 de octubre de 2020 [citado 20 de abril de 2024];48(2):e48232616. Disponible en: https://www.produccioncientificaluz.org/index.php/kasmera/article/view/32616
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