Cytopathology . SARS-CoV-2 RNA may rarely be present in a uterine cervix LBC sample at the asymptomatic early stage of COVID 19 disease

[tetano]

Cytopathology


. 2021 May 25.
doi: 10.1111/cyt.12995. Online ahead of print.
SARS-CoV-2 RNA may rarely be present in a uterine cervix LBC sample at the asymptomatic early stage of COVID 19 disease


Ondrej Ondič ^{1 2} , Kateřina Černá ^{1 2} , Iva Kinkorová-Luňáčková ² , Jana Němcová ^{1 2} , Bořivoj Mejchar ³ , Jan Chytra ⁴ , Jiří Bouda ⁴



Affiliations

• PMID: 34033165
• DOI: 10.1111/cyt.12995

Abstract

Background: 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 unaware that they were exposed to 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 years 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. This is the first dedicated study of the infectious potential of PAP smear. It includes one positive liquid based (LBC) sample paired with positive nasopharyngeal swab RT- PCR SARS CoV-2 test. A significance of this finding is discussed. Finally, the current approach to LBC samples is reinforced. Two-Liner Summary.

Keywords: COVID-19; LBC; PAP smear; PCR; SARS-CoV-2; coronavirus.