COVID-19 pandemic : guidance for nuclear medicine departments

Abstract

Coronaviruses are non-segmented, enveloped positive-sense ribonucleic acid viruses from the Coronaviridae family. There are six types of the coronavirus known to infect humans. Four of them cause mild respiratory symptoms, while two of them, the Middle East respiratory syndrome coronavirus (MERS) and the severe acute respiratory syndrome (SARS), have caused epidemics with high mortality rates. In December 2019, a new type of coronavirus 2019-nCoV/ SARS-CoV-2, causing COVID-19 disease, was extracted and identified from the lower respiratory tract samples of several patients in Wuhan, China. These patients presented with symptoms of severe pneumonia, including fever, fatigue, dry cough, and respiratory distress. The coronavirus disease 19 (COVID-19) is a highly transmittable and pathogenic viral infection. It is believed to be transmitted via respiratory droplets and fomites during close unprotected contact between an infector and an infectee. The coronaviruses mainly infect epithelial cells in the lung, but SARS-CoV-2 has been detected in respiratory, fecal, and blood specimens of patients infected with the virus. On February 3, 2020, the World Health Organization declared a public health emergency of international concern, and on March 11, declared COVID-19 a pandemic. The total number of confirmed cases, deaths associated with COVID19, and affected countries and territories continues to grow; detailed statistics can be found at the WHO–Coronavirus disease (COVID-19) Pandemic site or the John Hopkins Coronavirus Resource Centre. Health care providers around the world are facing challenging decisions. They are rapidly adjusting their standard operating procedures (SOPs) to cope with the pandemic cases and deliver their services. This is done in line with local guidance, resources available, and the advice of the World Health Organization (WHO) Minimum Requirements for infection prevention and control (IPC) programmes. This publication was prepared based on the systematic review of available literature on the subject and the contribution of a panel of international experts during the webinar entitled “Coronavirus disease (COVID-19) Pandemic: Challenges for the Nuclear Medicine Departments,” organized by the International Atomic Energy Agency (IAEA) and broadcasted live on Wednesday 25 March 2020. The objective of this guide is not to override any local guidance or national practice guidelines or rules, nor does it provide comprehensive advice on all aspects of nuclear medicine practice. It is solely intended as advice for nuclear medicine facilities during this time of adjustment and adaptation to the COVID-19 pandemic. We present suggested recommendations for nuclear medicine departments to follow, based on a typical patient’s “journey” through the department.