University of Genoa, Genoa, Italy (Department of Health Sciences (DISSAL)).
IRCCS Ospedale Policlinico San Martino, Genoa, Italy (Occupational Medicine Unit).
Int J Occup Med Environ Health. 2021 May 27;34(2):189-201. doi: 10.13075/ijomeh.1896.01759. Epub 2021 Apr 1.
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.
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.
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.
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.
本研究旨在评估医学院医生和住院医师（主要是年轻医生）中 SARS-CoV-2 感染的临床特征和负担。对 COVID-19 临床表现的认识可以提高对轻症病例的早期发现，从而可能减少对同事和患者的进一步传播。
本研究于 2020 年 3 月至 5 月在意大利北部一家教学医院进行，调查对象为该医院的 881 名医生。采用结构化表格收集临床和流行病学信息进行数据收集。
共有 162 名医生因急性呼吸道症状或与确诊 COVID-19 病例密切接触而联系职业健康服务。在确诊的 COVID-19 病例中，大多数是住院医师阶段的男性医生，85%表现为轻症。发热（70.3%）和咳嗽（51.4%）是 COVID-19 的最常见症状。单因素分析显示，实时逆转录聚合酶链反应（RT-PCR）阳性率随年龄增加而升高（OR=1.08，95%CI：1.02-1.14，p=0.012），在 COVID-19 病房工作（OR=3.33，95%CI：1.09-10.21，p=0.031）、嗅觉/味觉改变或丧失（OR=10.00，95%CI：2.80-35.69，p<0.001）和肌痛（OR=3.20，95%CI：1.00-10.26，p=0.046）的发生率增加，而住院医师（OR=0.20，95%CI：0.05-0.80，p=0.030）感染的可能性降低。年龄和嗅觉/味觉丧失是与 RT-PCR 阳性相关的唯一独立因素。
大多数 COVID-19 病例表现为轻症综合征，从无症状或症状稀少到普通感冒或流感样症状不等。本研究结果提高了对 COVID-19 疑似病例的临床诊断准确性，有助于及时识别和管理，在 SARS-CoV-2 大流行的再次爆发期间尤为有用。国际职业医学与环境卫生杂志。2021；34（2）：189-201。
