Gert van der Hoek
In Memoriam - Editor, Senior Moderator
Abstract
COVID-19 is spreading rapidly over the world. On February 27, 2020, the first patient with COVID-19 was reported in the Netherlands, linked to a trip to Northern Italy. In the following weeks, we identified nine Health Care Workers (HCW) of whom eight had no epidemiological link to countries with a high incidence of COVID-19 at that time. This suggested local spread of SARS-CoV-2 in the community and prompted a low-threshold screening in HCWs.
Screening was performed in two large teaching hospitals in the southern part of the Netherlands. HCWs who suffered from fever or mild respiratory symptoms were tested for SARS-CoV-2 by RT-PCR on oropharyngeal samples. Structured interviews were conducted to document symptoms. Eighty-six (6.4%) out of 1,353 HCWs were infected with SARS-Cov-2. The median age was 49 years and 15 (17.4%) were male. Most suffered from relatively mild disease. Only 46 (53.5%) HCWs had fever during the course of illness. Seventy-nine (91.9%) HCWs met a case definition of fever and/or coughing and/or shortness of breath.
The majority (n=54, 62.8%) reported to have worked while being symptomatic. Within one week after the first case was reported, a substantial proportion of HCWs with fever or respiratory symptoms were proven to be infected with SARS-Cov-2. This observation suggests that there is a relatively high prevalence of mild clinical presentations that may go undetected. The spectrum of symptoms present in HCWs with COVID-19, frequently not including fever, asks for less stringent use of the currently recommended case-definition for suspected COVID-19.
COVID-19 is spreading rapidly over the world. On February 27, 2020, the first patient with COVID-19 was reported in the Netherlands, linked to a trip to Northern Italy. In the following weeks, we identified nine Health Care Workers (HCW) of whom eight had no epidemiological link to countries with a high incidence of COVID-19 at that time. This suggested local spread of SARS-CoV-2 in the community and prompted a low-threshold screening in HCWs.
Screening was performed in two large teaching hospitals in the southern part of the Netherlands. HCWs who suffered from fever or mild respiratory symptoms were tested for SARS-CoV-2 by RT-PCR on oropharyngeal samples. Structured interviews were conducted to document symptoms. Eighty-six (6.4%) out of 1,353 HCWs were infected with SARS-Cov-2. The median age was 49 years and 15 (17.4%) were male. Most suffered from relatively mild disease. Only 46 (53.5%) HCWs had fever during the course of illness. Seventy-nine (91.9%) HCWs met a case definition of fever and/or coughing and/or shortness of breath.
The majority (n=54, 62.8%) reported to have worked while being symptomatic. Within one week after the first case was reported, a substantial proportion of HCWs with fever or respiratory symptoms were proven to be infected with SARS-Cov-2. This observation suggests that there is a relatively high prevalence of mild clinical presentations that may go undetected. The spectrum of symptoms present in HCWs with COVID-19, frequently not including fever, asks for less stringent use of the currently recommended case-definition for suspected COVID-19.