Letter to the Editor
Immune audit of COVID-19 at the department of ophthalmology of a tertiary hospital before deconfinement
Auditoría inmunitaria de COVID-19 en el servicio de oftalmología de un hospital de tercer nivel antes del desconfinamiento
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Gegúndez-Fernández, J. Zarranz-Ventura, G. Garay-Aramburu, F.J. Muñoz-Negrete, J. Mendicute del Barrio, L. Pablo-Júlvez, S. García-Delpech, A. López-Alemany, F. Arnalich-Montiel, M. Cordero-Coma, J.A. Cárceles" "autores" => array:12 [ 0 => array:2 [ "nombre" => "J.A." "apellidos" => "Gegúndez-Fernández" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Zarranz-Ventura" ] 2 => array:2 [ "nombre" => "G." "apellidos" => "Garay-Aramburu" ] 3 => array:2 [ "nombre" => "F.J." "apellidos" => "Muñoz-Negrete" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Mendicute del Barrio" ] 5 => array:2 [ "nombre" => "L." "apellidos" => "Pablo-Júlvez" ] 6 => array:2 [ "nombre" => "S." "apellidos" => "García-Delpech" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "López-Alemany" ] 8 => array:2 [ "nombre" => "F." "apellidos" => "Arnalich-Montiel" ] 9 => array:2 [ "nombre" => "M." "apellidos" => "Cordero-Coma" ] 10 => array:2 [ "nombre" => "J.A." 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Garrido-Hermosilla, M. Caro-Magdaleno, J.F. Moreno-Galdo, E. Rodríguez-de-la-Rúa-Franch" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A.M." "apellidos" => "Garrido-Hermosilla" "email" => array:1 [ 0 => "gaherfamily@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Caro-Magdaleno" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "J.F." "apellidos" => "Moreno-Galdo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "E." "apellidos" => "Rodríguez-de-la-Rúa-Franch" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Gestión Clínica de Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "RETICS OftaRed, Instituto de Salud Carlos III, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Auditoría inmunitaria de COVID-19 en el servicio de oftalmología de un hospital de tercer nivel antes del desconfinamiento" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2341 "Ancho" => 2341 "Tamanyo" => 316662 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) photograph showing the extraction of a capillary total blood sample from a fingertip. B) negative results of a fast test taken by an ophthalmologist of the authors’ department. C) report certifying the results of the diagnostic test.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Up to April 20, 2020, COVID-19 (English acronym for <span class="elsevierStyleItalic">coronavirus disease</span> 2019) has affected 204,178 people in Spain and caused the dismal number of 21,282 deaths<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">,</span> including our colleague from Valencia, Dr. Vicente Sánchez. From here we extend our heartfelt sympathy and condolences to his family.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the past 10 days the tide of the pandemic seems to be turning as shown by indicators in our country, with regularly decreasing numbers of contagions and daily deaths<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a>. For this reason, health authorities are beginning to plan a possible transitional phase, known as “descaling”, (an English-language term that is not approved by the Royal Academy of the Spanish Language) for existing healthcare conditions.</p><p id="par0015" class="elsevierStylePara elsevierViewall">However, it is well-known that accessibility to SARS-CoV-2 tests (severe acute respiratory syndrome coronavirus 2), the virus that has caused COVID-19, has been and continues to be limited for health professionals.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In these circumstances, in our department we have personally purchased 40 VivaDiag<span class="elsevierStyleSup">TM</span> quick tests for COVID-19 IgM/IgG (VivaChek™ Biotech Co., Ltd., Hangzhou, China). This test makes a qualitative assessment of IgM and IgG antibodies against SARS-CoV-2. The cost of this test is low and it is very simple to make, as can be seen in <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A . No equipment is necessary to assess the results of the test, which can be read in 15<span class="elsevierStyleHsp" style=""></span>min (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). In what concerns diagnostic reliability, the manufacturers report a specificity of 100% and sensitivity of 81.25% between day 4 and day 10 of the infection, and 97.1% between between days 11 and 24<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a>. However, as indicated by the website of the Health Ministry, the National Microbiology Center has assessed the reliability of this test with samples of patients from hospitals in different regions of Spain, and confirm 100% specificity as reported by the lab but lower sensitivity (64%) when applied to patients without taking into account evolution time, and of approximately 80% in patients with over 7 days evolution of the disease<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a>. The main drawback of these quick tests is that they are not useful during the first days of infection because antibodies against virus start being produced as from day 6 since the onset of symptoms<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a>. Therefore, it would be convenient to combine this test with the polymerase chain reaction (PCR) which continues to be the reference diagnostic test.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The study initiated by our department had 2 main objectives: to determine whether an ophthalmologist in the department, none of whom had symptoms, was an asymptomatic case, and also to determine whether anyone had endured the infection asymptomatically and was immune to the virus. The idea was to plan clinic and surgical care strategies for the future. None of the 40 tested ophthalmologists was positive for IgM and/or IgG. This result was verified by 2 ophthalmologists of our department, obviously not those who were tested, utilizing a certification record specifically designed for the purpose (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C).</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the light of the results of this study, it is clear that we should continue maintaining safety measures in our healthcare practice, both in consultations and surgery rooms, at least until an effective vaccine becomes available. Consequently, we call on ophthalmologists who have not yet tested their immunity against the virus to do so at the earliest possible time, particularly if they work in the regions that are most affected by the pandemic. Let us remain steadfast, we shall prevail.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Garrido-Hermosilla AM, Caro-Magdaleno M, Moreno-Galdo JF, Rodríguez-de-la-Rúa-Franch E. Auditoría inmunitaria de COVID-19 en el servicio de oftalmología de un hospital de tercer nivel antes del desconfinamiento. Arch Soc Esp Oftalmol. 2020;95:311–312.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2341 "Ancho" => 2341 "Tamanyo" => 316662 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) photograph showing the extraction of a capillary total blood sample from a fingertip. B) negative results of a fast test taken by an ophthalmologist of the authors’ department. C) report certifying the results of the diagnostic test.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Instituto de Salud Carlos III, Madrid; 2020.Situación de COVID-19 en España [updated 20 Apr 2020; accessed 20 Apr 2020]. Available from: https://covid19.is https://covid19.isciii.es/ciii.es/" ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Clinical Study Report of VivaDiagTM COVID-19 IgM & IgG Rapid Test. Hangzhou: VivaChek Biotech Co., Ltd.; 2020." ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ministerio de Salud, Consumo y Bienestar Social 2020. Guía para la utilización de test rápidos de anticuerpos para COVID-19 [updated 7 Apr 2020; accessed 20 Apr 2020] Available from: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Guia_test_diagnosticos_serologicos_20200407.pdf" ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009500000006/v1_202006140809/S2173579420300888/v1_202006140809/en/main.assets" "Apartado" => array:4 [ "identificador" => "5813" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009500000006/v1_202006140809/S2173579420300888/v1_202006140809/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579420300888?idApp=UINPBA00004N" ]
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