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Pulmonary Function Laboratories: Advice Regarding COVID-19

Advice Regarding COVID 19 For Pulmonary Function Laboratories

Concern has been raised that pulmonary function testing could represent a potential avenue for COVID 19 transmission due to the congregation of patients with lung disease and because of the potential for coughing and droplet formation surrounding pulmonary function testing procedures. We recognize that most patients are screened for symptoms and travel before entry into our health care systems, but it is more difficult to screen and assess pulmonary patients who are more likely to have respiratory symptoms unrelated to COVID 19.  There remain many unknowns about the possibility of transmission in this setting and the data are in evolution; however, the risks of transmission may be significant, and likely vary based on the prevalence of the virus in the community and the age, severity of lung disease and presence of immunosuppression.

We recommend that pulmonary function testing be limited to tests that are only essential for immediate treatment decisions, that the type of pulmonary function testing be limited to the most essential tests when possible, and that measures to protect both the staff and individuals being tested should be put in place. Protective measures include personal protective equipment (PPE) that limits aerosolized droplet acquisition for staff and enhanced cleaning of the testing space such as wiping down surfaces with appropriate cleaners.  Use of PPE should be considered in discussions with your infection control team.

Decisions regarding the conduct of pulmonary function tests need to balance the potential risks against the need for assessment of lung function to make treatment decisions. We realize that this is an evolving situation and that the risk/benefit ratio will also continue to change over time.

Meredith C. McCormack, MD MHS

David A. Kaminsky, MD

2020 members of the ATS Proficiency Standards for Pulmonary Function Testing Committee