Cytology in the time of coronavirus disease (COVID-19): an Italian perspective

Introduction The coronavirus disease 2019 (COVID-19) is changing the way we practice pathology, including fine needle aspiration (FNA) diagnostics. Although recommendations have been issued to prioritise patients at high oncological risk, postponing those with unsuspicious presentations, real world data have not been reported yet. Methods The percentages of the cytological sample types processed at the University of Naples Federico II, during the first 3 weeks of Italian national lockdown were compared with those of the same period in 2019. Results During the emergency, the percentage of cytology samples reported as malignant increased (p<0.001), reflecting higher percentages of breast (p=0.002) and lymph nodes FNAs (p=0.008), effusions (p<0.001) and urine (p=0.005). Conversely, thyroid FNAs (p<0.001) and Pap smears (p=0.003) were reduced. Conclusions Even in times of COVID-19 outbreak, cytological examination may be safely carried out in patients at high oncological risk, without the need to be postponed.

Automated summary

Cytological examination can be safely conducted in patients at high oncological risk even during the COVID-19 outbreak, without the need for postponement. The study found that during the emergency, there was an increase in the percentage of cytology samples reported as malignant, particularly in breast and lymph node FNAs, effusions, and urine, while thyroid FNAs and Pap smears decreased.