ORIGINAL PAPER
Clinical and epidemiological characteristics of COVID-19 during the early phase of the SARS-CoV-2 pandemic: a cross-sectional study among medical school physicians and residents employed in a regional reference teaching hospital in Northern Italy
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1
University of Genoa, Genoa, Italy
(Department of Health Sciences (DISSAL))
2
IRCCS Ospedale Policlinico San Martino, Genoa, Italy
(Occupational Medicine Unit)
3
IRCCS Ospedale Policlinico San Martino, Genoa, Italy
(Hygiene Unit)
Online publication date: 2021-04-01
Corresponding author
Paolo Durando
University of Genoa, Department of Health Sciences (DISSAL), Via A. Pastore 1, 16132 Genoa, Italy
Int J Occup Med Environ Health. 2021;34(2):189-201
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ABSTRACT
Objectives: The aim of the study was to evaluate the clinical presentation and burden of SARS-CoV-2 infections among medical school physicians and
residents, mainly young medical doctors. The awareness of COVID‑19 clinical manifestations can improve the early detection of mild cases, possibly reducing
further transmission to colleagues and patients. Material and Methods: The study was carried out in March–May 2020, involving medical school
physicians in a teaching hospital in northern Italy, with a working population of 881 medical doctors. Data collection was performed using a structured
form investigating clinical and epidemiological information. Results: One hundred sixty-two medical doctors contacted the Occupational Health Service
reporting acute respiratory symptoms or close contact exposure to a confirmed COVID‑19 case. Among the confirmed COVID‑19 cases, most
were male doctors during residency, and 85% presented a mild clinical picture. Fever (70.3%) and cough (51.4%) represented the most prevalent
symptoms of COVID‑19. As revealed by the univariate analysis, the prevalence of real-time reverse transcriptase-polymerase chain reaction (RT-PCR)
positivity increased with age (OR = 1.08, 95% CI: 1.02–1.14, p = 0.012), working in a COVID‑19 ward (OR = 3.33, 95% CI: 1.09–10.21, p = 0.031),
presenting alteration or loss of smell/taste (OR = 10.00, 95%CI: 2.80–35.69, p < 0.001) and myalgia (OR = 3.20, 95% CI: 1.00–10.26, p = 0.046), while
being a resident (OR = 0.20, 95% CI: 0.05–0.80, p = 0.030) was associated with reduced odds of being infected, compared to staff physicians. Age and
loss of smell/taste were the only factors independently associated with RT-PCR positivity. Conclusions: The majority of COVID‑19 cases showed a mild clinical syndrome, ranging from absence or paucity of symptoms to common cold or influenza-like symptoms. The findings of the present study increase
the accuracy of the clinical diagnosis for the prompt identification and management of suspected COVID‑19 cases, being particularly useful during
resurges of the SARS-CoV-2 pandemic. Int J Occup Med Environ Health. 2021;34(2):189–201