OBJECTIVE: Currently, it is thought that uterine cervix mucosal samples present a low risk of SARS-CoV-2 exposure. So far, there is no evidence of SARS-CoV-2 detection in Papanicolaou (Pap) smears. Nevertheless, clinicians could be exposed unaware to the coronavirus while performing and handling a Pap smear. We aimed to retrospectively evaluate the presence of SARS-CoV-2 RNA in cervical liquid-based cytology (LBC) samples in women who tested positive for a nasopharyngeal COVID-19 PCR test. METHODS: From our laboratory database, we identified patients with data on a cervical cancer screening LBC sample paired with a positive nasopharyngeal COVID-19 PCR test. Relevant LBC samples taken within an incubation period of 14 days and post-onset RNA shedding interval of 25 days were subsequently tested for SARS-CoV-2 RNA using RT-PCR tests. RESULTS: The study group consisted of 102 women. Of those, 23 LBC samples were tested. SARS-CoV-2 RNA was detected in one LBC sample from a 26-year-old asymptomatic woman taken six days before reporting headaches and knee arthralgia with a positive nasopharyngeal SARS-CoV-2 RT-PCR test. CONCLUSIONS: It is possible to detect SARS-CoV-2 RNA in cervical LBC samples at an early asymptomatic stage of COVID-19. In general, this finding is infrequent in asymptomatic women who tested SARS-CoV-2 positive within an incubation of 14 days and a post-onset RNA shedding period of 25 days. We fully support the current thinking that cervical LBC samples from asymptomatic women pose a low risk of SARS-CoV-2 exposure and can be handled in the frame of good microbiological practice and procedures.

Bioptická Laboratoř s r o Pilsen Czech Republic

Department of Gynecology and Obstetrics Medical Faculty Charles University and Charles University Hospital Pilsen Pilsen Czech Republic

Department of Pathology Medical Faculty Charles University and Charles University Hospital Pilsen Pilsen Czech Republic

Private Gynaecologist Office Pilsen Czech Republic

Zobrazit více v PubMed

Vigliar E, Cepurnaite R, Alcaraz‐Mateos E, et al. Global impact of the COVID‐19 pandemic on cytopathology practice: results from an international survey of laboratories in 23 countries. Cancer Cytopathol. 2020;128:885‐894. PubMed

Wang YH, Bychkov A, Chakrabarti I, et al. Impact of the COVID‐19 pandemic on cytology practice: an international survey in the Asia‐Pacific region. Cancer Cytopathol. 2020;128:895‐904. PubMed

Virk RK, Wood T, Tiscornia‐Wasserman PG. Impact of COVID‐19 pandemic on functioning of cytopathology laboratory: Experience and perspective from an academic centre in New York. Cytopathology. 2021;32(3):304‐311. PubMed PMC

World Health Organisation (WHO) . Laboratory testing for coronavirus disease 2019 (COVID‐19) in suspected human cases. https://www.who.int/publications‐detail/laboratory‐testing‐for‐2019‐novel‐coronavirus‐in‐suspected‐humancases‐20200117. Accessed February 10, 2021

European Centre for Disease Prevention and Control . Infection prevention and control and preparedness for COVID‐19 in healthcare settings ‐ Sixth update. February 9, 2021. ECDC: Stockholm; 2021.

CEN Workshop AGREEMENT . CWA 15793 ‐ Laboratory biorisk management. https://www.aimst.edu.my/ibc/pdf/Guidelines/10.%20CWA%2015793,%202011.pdf. Accessed February 10, 2021

Ronchi A, Pagliuca F, Zito Marino F, Montella M, Franco R, Cozzolino I. Interventional cytopathology in the COVID‐19 era. Cytopathology. 2020;31:509‐513. PubMed PMC

Chen CC, Chi CY. Biosafety in the preparation and processing of cytology specimens with potential coronavirus (COVID‐19) infection: perspectives from Taiwan. Cancer Cytopathol. 2020;128:309‐316. PubMed PMC

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. 2020;128:317‐320. PubMed PMC

Iaccarino A, Pisapia P, Vigliar E, Vielh P, Troncone G. Juggling the COVID‐19 pandemic: a cytopathology point of view. Cytopathology. 2021;32(3):299‐303. PubMed

Backer JA, Klinkenberg D, Wallinga J. Incubation period of 2019 novel coronavirus (2019‐nCoV) infections among travellers from Wuhan, China, 20–28 January 2020. Euro Surveill. 2020;25(5):2000062. PubMed PMC

Liu Y, Yan LM, Wan L, et al. Viral dynamics in mild and severe cases of COVID‐19. Lancet Infect Dis. 2020;20:656‐657. PubMed PMC

Lescure FX, Bouadma L, Nguyen D, et al. Clinical and virological data of the first cases of COVID‐19 in Europe: a case series. Lancet Infect Dis. 2020;20:697‐706. PubMed PMC

Carsana L, Sonzogni A, Nasr A, et al. Pulmonary post‐mortem findings in a series of COVID‐19 cases from northern Italy: a two‐centre descriptive study. Lancet Infect Dis. 2020;20:1135‐1140. PubMed PMC

Schurink B, Roos E, Radonic T, et al. Viral presence and immunopathology in patients with lethal COVID‐19: a prospective autopsy cohort study. Lancet Microbe. 2020;1:e290‐e299. PubMed PMC

Calabrese F, Pezzuto F, Fortarezza F, et al. Pulmonary pathology and COVID‐19: lessons from autopsy. The experience of European Pulmonary Pathologists. Virchows Arch. 2020;477:359‐372. PubMed PMC

Skok K, Stelzl E, Trauner M, et al. Post‐mortem viral dynamics and tropism in COVID‐19 patients in correlation with organ damage. Virchows Arch. 2021;478(2):343‐353. PubMed PMC

Coccolini F, Tartaglia D, Puglisi A, et al. SARS‐CoV‐2 is present in peritoneal fluid in COVID‐19 patients. Ann Surg. 2020;272:e240‐e242. PubMed PMC

Lersy F, Benotmane I, Helms J et al. Cerebrospinal fluid features in patients with coronavirus disease 2019 and neurologic manifestations: correlation with brain magnetic resonance imaging findings in 58 patients. J Infect Dis. 2021;223:600‐609. PubMed PMC

Gonzalez DC, Khodamoradi K, Pai R, et al. A systematic review on the investigation of SARS‐CoV‐2 in semen. Res Rep Urol. 2020;12:615‐621. PubMed PMC

Bertino E, Moro GE, De Renzi G, et al. Detection of SARS‐CoV‐2 in milk from COVID‐19 positive mothers and follow‐up of their infants. Front Pediatr. 2020;8:597699. PubMed PMC

Gagneur A, Dirson E, Audebert S, et al. Materno‐fetal transmission of human coronaviruses: a prospective pilot study. Eur J Clin Microbiol Infect Dis. 2008;27:863‐866. PubMed PMC

Joynt GM, Wu WK. Understanding COVID‐19: what does viral RNA load really mean? Lancet Infect Dis. 2020;20:635‐636. PubMed PMC