Samples with a cycle threshold of internal control (IC) ranging between 5.0 and 25 and no amplification of the viral genome targets were classified as SARS-CoV-2 not detectable, while samples with a cycle threshold ranging between 5.0 and 25 of IC and any amplification of the viral genome targets of two distinct regions within the N gene of SARS-CoV-2 were classified as SARS-CoV-2 detectable. control (IC) ranging between 5.0 and 25 and no amplification of the viral genome targets were classified as SARS-CoV-2 not detectable, while samples with a cycle threshold ranging between 5.0 and 25 of IC and any amplification of the viral genome targets of two distinct regions within the N gene of SARS-CoV-2 were classified as SARS-CoV-2 detectable. Results were available within 24C48?h after sampling. We tested scheduled patients during the preoperative assessment clinic visit 2?days before surgery and urgent patients on entering the ER. In the case of positive result, nonurgent patients were rescheduled. Health-care staff were routinely tested every 10C20?days. Test for past contamination SARS-CoV-2 specific IgM and IgG antibodies quantification in serum samples of patients were measured by chemiluminescent immunoassay (MAGLUMI 800 platform, Snibe, Shenzhen, PRC) showing calculated clinical sensitivities of IgM and IgG were 78.6% and 91.2%, respectively, while specificities of IgM and IgG were 97.5% and 97.3%, respectively. According to the manufacturer, antibodies used in the direct assays were against both CoV-S (spike) and CoV-N (nucleocapside) the main immunogens proteins of this coronavirus. These types of antibodies seem to correlate with neutralizing antibodies responses.6 Results of IgG assessment were interpreted as follows: (i) reactive if 1.1?AU/mL; (ii) not reactive if 0.9; (iii) borderline if between 0.9 and 1.1?AU/mL. A single cut off limit of 1 1.0 for BC2059 IgM was proposed.7 Results were available within 48?h after sampling. We tested scheduled patients during the preoperative assessment clinic visit 2?days before surgery, and urgent patients the day of surgery. All patients repeated screening at 1-month visit after keratoplasty. Arrangement of the eye surgery Patients had to comply with the assigned appointment time (neither too early nor late) to avoid crowding of people in the waiting rooms. The personnel of the Ophthalmic Unit supplied written instructions to patients. The COVID-19 free pathway Patients scheduled for corneal transplantation who accepted the operation after a phone call, verified negative at the evaluation of symptoms and risk factors accessed the hospital for the preoperative clinic assessment visit 2?days before surgery. Surgery was carried out 2?days after, under local or general anesthesia, and patients went home on the same day, though some required an overnight stay. To enter the OR, patients wore a disposable surgical mask, and 100% polypropylene hydrophobic cap, gown, and overshoes. Supplemental oxygen airflow under the surgical drapes was delivered to patients by nasal cannula. The OR has a reserved scrub facility, individual BC2059 access for personnel, and patients were moved in and out of the operating block through a patient transfer unit, lying down on a stretcher. In Rabbit polyclonal to ARHGAP20 the case of overnight stay, patients were hosted in a reserved COVID-19 room (pathway especially arranged to cope with the COVID-19 pandemic while maintaining surgical activities for the emergent non-deferrable surgical cases. Such patients were considered in any case positive for SARS-CoV-2 infection and BC2059 followed the triage evaluation and nasopharyngeal swab sampling on entry to the ER, wore surgical masks and gloves and were moved in a wheelchair through a one-way COVID-19 pathway to the Ophthalmic Unit for evaluation, and then to a COVID-19 waiting room next to the operating block. Patients moved to the COVID-19 OR, a room properly set up for COVID-19 positive patients and service guaranteed 24?h by an anesthetist and assistant (the area of the hospital suitable to host suspected or confirmed positive patients, BC2059 on a different level of the same building as the operating block. Asymptomatic patients would eventually move to a different exclusive hospital for SARS-CoV-2 infected subjects (surgical pathway because they showed corneal perforation following severe bacterial infection requiring urgent keratoplasty. The same ophthalmic surgical team was involved in all surgery and clinical assessments. Endothelial keratoplasty was performed in 16 patients (9 Descemet stripping automated endothelial keratoplasty, DSAEK, and.