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A COVID-19 outbreak in a rheumatology department upon the early days of the pandemic

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dc.contributor.authorRomão, Vasco C.
dc.contributor.authorOliveira Ramos, Filipa
dc.contributor.authorMachado, Ana Rita
dc.contributor.authorMartins, Patrícia
dc.contributor.authorBarreira, Sofia
dc.contributor.authorSilva-Dinis, Joana
dc.contributor.authorGalaio, Luís Mendonça
dc.contributor.authorProença, Helena
dc.contributor.authorCristino, José Melo
dc.contributor.authorLeite, Ema
dc.contributor.authorKhmelinskii, Nikita
dc.contributor.authorRomeu, José
dc.contributor.authorFonseca, João Eurico
dc.date.accessioned2021-03-04T18:06:58Z
dc.date.available2021-03-04T18:06:58Z
dc.date.issued2020
dc.descriptionCopyright © 2020 Cascão, Vidal, Carvalho, Lopes, Romão, Goncalves, Moita andFonseca. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.pt_PT
dc.description.abstractObjectives: To describe our experience with a coronavirus disease 2019 (COVID-19) outbreak within a large rheumatology department early in the pandemic. Methods: Symptomatic and asymptomatic healthcare workers (HCWs) had a naso-oropharyngeal swab for detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and were followed clinically. Reverse transcription polymerase-chain reaction (RT-PCR) was repeated to document cure, and serological response was assessed. Patients with risk contacts within the department in the 14 days preceding the outbreak were screened for COVID-19 symptoms. Results: 14/34 HCWs (41%; 40 ± 14 years, 71% female) tested positive for SARS-CoV-2, and 11/34 (32%) developed symptoms but were RT-PCR-negative. Half of RT-PCR-positive HCWs did not report fever, cough, or dyspnea before testing, which were absent in 3/14 cases (21%). Mild disease prevailed (79%), but 3 HCWs had moderate disease requiring further assessment, which excluded severe complications. Nevertheless, symptom duration (28 ± 18 days), viral shedding (31 ± 10 days post-symptom onset, range 15-51), and work absence (29 ± 28 days) were prolonged. 13/14 (93%) of RT-PCR-positive and none of the RT-PCR-negative HCWs had a positive humoral response Higher IgG indexes were observed in individuals over 50 years of age (14.5 ± 7.7 vs. 5.0 ± 4.4, p = 0.012). Of 617 rheumatic patients, 8 (1.3%) developed COVID-19 symptoms (1/8 hospitalization, 8/8 complete recovery), following a consultation/procedure with an asymptomatic (7/8) or mildly symptomatic (1/8) HCW. Conclusions: A COVID-19 outbreak can occur among HCWs and rheumatic patients, swiftly spreading over the presymptomatic stage. Mild disease without typical symptoms should be recognized and may evolve with delayed viral shedding, prolonged recovery, and adequate immune response in most individuals.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationFront Med. 2020 Sep 25;7:576162.pt_PT
dc.identifier.doi10.3389/fmed.2020.576162pt_PT
dc.identifier.eissn2095-0225
dc.identifier.issn2095-0217
dc.identifier.urihttp://hdl.handle.net/10451/46664
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherFrontierspt_PT
dc.relation.publisherversionhttps://www.frontiersin.org/journals/medicinept_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectCOVID-19pt_PT
dc.subjectHealthcare workers (HCW)pt_PT
dc.subjectPresymptomatic transmissionpt_PT
dc.subjectRheumatic patientspt_PT
dc.subjectRheumatology practicept_PT
dc.titleA COVID-19 outbreak in a rheumatology department upon the early days of the pandemicpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleFrontiers in Medicinept_PT
oaire.citation.volume7pt_PT
person.familyNameC Romão
person.familyNameMachado
person.familyNameMartins
person.familyNameBarreira
person.familyNameGalaio
person.familyNameMelo Cristino
person.familyNameLeite
person.familyNameKhmelinskii
person.familyNameRomeu
person.familyNameFonseca
person.givenNameVasco
person.givenNameAna Rita
person.givenNamePatrícia
person.givenNameSofia
person.givenNameLuis
person.givenNameJosé
person.givenNameEma
person.givenNameNikita
person.givenNameJosé
person.givenNameJoão
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rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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