Feasibility for SARS-CoV-2 tests in the hospital: an Exposure Analysis and Critical Control Points approach

CUI Zelin1, Sebastian Leptihn2, LI Mingyue3, GUO Mingquan4, GAO Jing5, LI Qingtian6, ZENG Lingbing7, ZHOU Yuhua8, WEI Yanxia9, GUO Xiaokui10, Nigel Temperton11, FENG Tingting12

Journal of Microbes and Infections ›› 2021, Vol. 16 ›› Issue (1) : 26-36.

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Journal of Microbes and Infections ›› 2021, Vol. 16 ›› Issue (1) : 26-36. DOI: 10.3969/j.issn.1673-6184.2021.01.004
Original Article

Feasibility for SARS-CoV-2 tests in the hospital: an Exposure Analysis and Critical Control Points approach

  •  CUI Zelin1, Sebastian Leptihn2, LI Mingyue3, GUO Mingquan4, GAO Jing5, LI Qingtian6, ZENG Lingbing7, ZHOU Yuhua8, WEI Yanxia9, GUO Xiaokui10, Nigel Temperton11, FENG Tingting12
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Abstract

This work aims to assess the feasibility of performing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA tests in hospitals and communities experiencing coronavirus disease 19 (COVID-19) outbreaks, to ultimately provide recommendations for hospitals with so-called fever clinics. In China, these specialized clinics within a hospital specifically receive outpatients with fever symptoms. A team with expertise in the Exposure Analysis and Critical Control Points (EACCP) framework identified potential infection routes during the testing for SARS-CoV-2, then constructed and tested flow diagrams, which were confirmed under actual conditions, demonstrating the feasibility to carry out in hospitals with fever clinics. The team determined critical control points to mitigate the exposure risks at each control point. The sampling and inactivation steps of clinical samples in fever clinics appeared to be associated with particularly high-risk levels of exposure to SARS-CoV-2. Moderate exposure levels were associated with storage and transportation of samples for inactivation. Low-risk levels associated with the transportation, storage, and detection steps after inactivation. To minimize infection risks for personnel, we proposed optimized processes to carry out SARS-CoV-2 RNA tests in hospitals with fever clinics in China. The high risk of SARS-CoV-2 exposure during procedures preceding testing is the sampling and biological inactivation. Simultaneously, full personal protective equipment and biosafety level-2 (BSL-2) laboratories in fever clinics or mobile BSL-2 laboratories could reduce the risk. Implementing the EACCP framework could facilitate rapid responses to outbreaks of emerging infectious diseases.

Key words

Coronavirus disease 19 / Severe acute respiratory syndrome coronavirus 2 / Hospital / Test / Fever clinic

 

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CUI Zelin1, Sebastian Leptihn2, LI Mingyue3, GUO Mingquan4, GAO Jing5, LI Qingtian6, ZENG Lingbing7, ZHOU Yuhua8, WEI Yanxia9, GUO Xiaokui10, Nigel Temperton11, FENG Tingting12. Feasibility for SARS-CoV-2 tests in the hospital: an Exposure Analysis and Critical Control Points approach[J]. Journal of Microbes and Infections. 2021, 16(1): 26-36 https://doi.org/10.3969/j.issn.1673-6184.2021.01.004

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