Prevalence and Clinical Presentation of Health Care Workers With Symptoms of Coronavirus Disease 2019 in 2 Dutch Hospitals During an Early Phase of the Pandemic
On February 27, 2020, the first patient with coronavirus disease 2019 (COVID-19) was reported in the Netherlands. During the following weeks, at 2 Dutch teaching hospitals, 9 health care workers (HCWs) received a diagnosis of COVID-19, 8 of whom had no history of travel to China or northern Italy, r...
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creator | Kluytmans-van den Bergh, Marjolein F Q Buiting, Anton G M Pas, Suzan D Bentvelsen, Robbert G van den Bijllaardt, Wouter van Oudheusden, Anne J G van Rijen, Miranda M L Verweij, Jaco J Koopmans, Marion P G Kluytmans, Jan A J W |
description | On February 27, 2020, the first patient with coronavirus disease 2019 (COVID-19) was reported in the Netherlands. During the following weeks, at 2 Dutch teaching hospitals, 9 health care workers (HCWs) received a diagnosis of COVID-19, 8 of whom had no history of travel to China or northern Italy, raising the question of whether undetected community circulation was occurring.
To determine the prevalence and clinical presentation of COVID-19 among HCWs with self-reported fever or respiratory symptoms.
This cross-sectional study was performed in 2 teaching hospitals in the southern part of the Netherlands in March 2020, during the early phase of the COVID-19 pandemic. Health care workers employed in the participating hospitals who experienced fever or respiratory symptoms were asked to voluntarily participate in a screening for infection with the severe acute respiratory syndrome coronavirus 2. Data analysis was performed in March 2020.
The prevalence of severe acute respiratory syndrome coronavirus 2 infection was determined by semiquantitative real-time reverse transcriptase-polymerase chain reaction on oropharyngeal samples. Structured interviews were conducted to document symptoms for all HCWs with confirmed COVID-19.
Of 9705 HCWs employed (1722 male [18%]), 1353 (14%) reported fever or respiratory symptoms and were tested. Of those, 86 HCWs (6%) were infected with severe acute respiratory syndrome coronavirus 2 (median age, 49 years [range, 22-66 years]; 15 [17%] male), representing 1% of all HCWs employed. Most HCWs experienced mild disease, and only 46 (53%) reported fever. Eighty HCWs (93%) met a case definition of fever and/or coughing and/or shortness of breath. Only 3 (3%) of the HCWs identified through the screening had a history of travel to China or northern Italy, and 3 (3%) reported having been exposed to an inpatient with a known diagnosis of COVID-19 before the onset of symptoms.
Within 2 weeks after the first Dutch case was detected, a substantial proportion of HCWs with self-reported fever or respiratory symptoms were infected with severe acute respiratory syndrome coronavirus 2, likely as a result of acquisition of the virus in the community during the early phase of local spread. The high prevalence of mild clinical presentations, frequently not including fever, suggests that the currently recommended case definition for suspected COVID-19 should be used less stringently. |
doi_str_mv | 10.1001/jamanetworkopen.2020.9673 |
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To determine the prevalence and clinical presentation of COVID-19 among HCWs with self-reported fever or respiratory symptoms.
This cross-sectional study was performed in 2 teaching hospitals in the southern part of the Netherlands in March 2020, during the early phase of the COVID-19 pandemic. Health care workers employed in the participating hospitals who experienced fever or respiratory symptoms were asked to voluntarily participate in a screening for infection with the severe acute respiratory syndrome coronavirus 2. Data analysis was performed in March 2020.
The prevalence of severe acute respiratory syndrome coronavirus 2 infection was determined by semiquantitative real-time reverse transcriptase-polymerase chain reaction on oropharyngeal samples. Structured interviews were conducted to document symptoms for all HCWs with confirmed COVID-19.
Of 9705 HCWs employed (1722 male [18%]), 1353 (14%) reported fever or respiratory symptoms and were tested. Of those, 86 HCWs (6%) were infected with severe acute respiratory syndrome coronavirus 2 (median age, 49 years [range, 22-66 years]; 15 [17%] male), representing 1% of all HCWs employed. Most HCWs experienced mild disease, and only 46 (53%) reported fever. Eighty HCWs (93%) met a case definition of fever and/or coughing and/or shortness of breath. Only 3 (3%) of the HCWs identified through the screening had a history of travel to China or northern Italy, and 3 (3%) reported having been exposed to an inpatient with a known diagnosis of COVID-19 before the onset of symptoms.
Within 2 weeks after the first Dutch case was detected, a substantial proportion of HCWs with self-reported fever or respiratory symptoms were infected with severe acute respiratory syndrome coronavirus 2, likely as a result of acquisition of the virus in the community during the early phase of local spread. The high prevalence of mild clinical presentations, frequently not including fever, suggests that the currently recommended case definition for suspected COVID-19 should be used less stringently.</description><identifier>ISSN: 2574-3805</identifier><identifier>EISSN: 2574-3805</identifier><identifier>DOI: 10.1001/jamanetworkopen.2020.9673</identifier><identifier>PMID: 32437576</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Adult ; Aged ; Betacoronavirus - isolation & purification ; Community-Acquired Infections - epidemiology ; Community-Acquired Infections - virology ; Coronavirus Infections - epidemiology ; Coronavirus Infections - virology ; Coronaviruses ; COVID-19 ; Cross Infection - epidemiology ; Cross Infection - virology ; Cross-Sectional Studies ; Female ; Fever ; Health Personnel ; Humans ; Infectious Diseases ; Male ; Middle Aged ; Netherlands - epidemiology ; Online Only ; Original Investigation ; Pandemics ; Pneumonia, Viral - epidemiology ; Pneumonia, Viral - virology ; Prevalence ; SARS-CoV-2 ; Self report ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; Teaching hospitals ; Young Adult</subject><ispartof>JAMA network open, 2020-05, Vol.3 (5), p.e209673-e209673</ispartof><rights>2020. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright 2020 Kluytmans-van den Bergh MFQ et al. .</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a470t-7b65d61fdb9615f317e3340ccffe86e5a37c59ae07efd2509362fcd5c8c88a2a3</citedby><cites>FETCH-LOGICAL-a470t-7b65d61fdb9615f317e3340ccffe86e5a37c59ae07efd2509362fcd5c8c88a2a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,864,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32437576$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kluytmans-van den Bergh, Marjolein F Q</creatorcontrib><creatorcontrib>Buiting, Anton G M</creatorcontrib><creatorcontrib>Pas, Suzan D</creatorcontrib><creatorcontrib>Bentvelsen, Robbert G</creatorcontrib><creatorcontrib>van den Bijllaardt, Wouter</creatorcontrib><creatorcontrib>van Oudheusden, Anne J G</creatorcontrib><creatorcontrib>van Rijen, Miranda M L</creatorcontrib><creatorcontrib>Verweij, Jaco J</creatorcontrib><creatorcontrib>Koopmans, Marion P G</creatorcontrib><creatorcontrib>Kluytmans, Jan A J W</creatorcontrib><title>Prevalence and Clinical Presentation of Health Care Workers With Symptoms of Coronavirus Disease 2019 in 2 Dutch Hospitals During an Early Phase of the Pandemic</title><title>JAMA network open</title><addtitle>JAMA Netw Open</addtitle><description>On February 27, 2020, the first patient with coronavirus disease 2019 (COVID-19) was reported in the Netherlands. During the following weeks, at 2 Dutch teaching hospitals, 9 health care workers (HCWs) received a diagnosis of COVID-19, 8 of whom had no history of travel to China or northern Italy, raising the question of whether undetected community circulation was occurring.
To determine the prevalence and clinical presentation of COVID-19 among HCWs with self-reported fever or respiratory symptoms.
This cross-sectional study was performed in 2 teaching hospitals in the southern part of the Netherlands in March 2020, during the early phase of the COVID-19 pandemic. Health care workers employed in the participating hospitals who experienced fever or respiratory symptoms were asked to voluntarily participate in a screening for infection with the severe acute respiratory syndrome coronavirus 2. Data analysis was performed in March 2020.
The prevalence of severe acute respiratory syndrome coronavirus 2 infection was determined by semiquantitative real-time reverse transcriptase-polymerase chain reaction on oropharyngeal samples. Structured interviews were conducted to document symptoms for all HCWs with confirmed COVID-19.
Of 9705 HCWs employed (1722 male [18%]), 1353 (14%) reported fever or respiratory symptoms and were tested. Of those, 86 HCWs (6%) were infected with severe acute respiratory syndrome coronavirus 2 (median age, 49 years [range, 22-66 years]; 15 [17%] male), representing 1% of all HCWs employed. Most HCWs experienced mild disease, and only 46 (53%) reported fever. Eighty HCWs (93%) met a case definition of fever and/or coughing and/or shortness of breath. Only 3 (3%) of the HCWs identified through the screening had a history of travel to China or northern Italy, and 3 (3%) reported having been exposed to an inpatient with a known diagnosis of COVID-19 before the onset of symptoms.
Within 2 weeks after the first Dutch case was detected, a substantial proportion of HCWs with self-reported fever or respiratory symptoms were infected with severe acute respiratory syndrome coronavirus 2, likely as a result of acquisition of the virus in the community during the early phase of local spread. The high prevalence of mild clinical presentations, frequently not including fever, suggests that the currently recommended case definition for suspected COVID-19 should be used less stringently.</description><subject>Adult</subject><subject>Aged</subject><subject>Betacoronavirus - isolation & purification</subject><subject>Community-Acquired Infections - epidemiology</subject><subject>Community-Acquired Infections - virology</subject><subject>Coronavirus Infections - epidemiology</subject><subject>Coronavirus Infections - virology</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - virology</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Fever</subject><subject>Health Personnel</subject><subject>Humans</subject><subject>Infectious Diseases</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Netherlands - epidemiology</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Pandemics</subject><subject>Pneumonia, Viral - epidemiology</subject><subject>Pneumonia, Viral - virology</subject><subject>Prevalence</subject><subject>SARS-CoV-2</subject><subject>Self report</subject><subject>Severe acute respiratory syndrome</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Teaching hospitals</subject><subject>Young Adult</subject><issn>2574-3805</issn><issn>2574-3805</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkttu1DAQhiMEolXpKyAjbrjZrQ-xndwgobSwSJVYCVAvLa8zabwkdrCdRfs2PCqOelDpla3xN__MeP6ieEfwmmBMLvZ61A7SHx9--QncmmKK17WQ7EVxSrksV6zC_OWT-0lxHuMe48wRVgv-ujhhtGSSS3Fa_N0GOOgBnAGkXYuawTpr9IByPIJLOlnvkO_QBvSQetToAOgm14YQ0Y3Nke_HcUp-jAvU-OCdPtgwR3RpI-gIKFetkXWIoss5mR5tfJxs0kMm5mDdbS6LrnQYjmjbL3yWST2gbe4GRmveFK-6DMP5_XlW_Px89aPZrK6_ffnafLpe6VLitJI7wVtBunZXC8I7RiQwVmJjug4qAVwzaXitAUvoWspxzQTtTMtNZapKU83Oio93utO8G6E1efagBzUFO-pwVF5b9f-Ls7269Qcl81_iGmeBD_cCwf-eISY12mhgGPK2_BwVLbFghNZkQd8_Q_d-Di6Pp6gQFeFMlgtV31Em-BgDdI_NEKwWK6hnVlCLFdRihZz79uk0j5kPi2f_ACDktvU</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Kluytmans-van den Bergh, Marjolein F Q</creator><creator>Buiting, Anton G M</creator><creator>Pas, Suzan D</creator><creator>Bentvelsen, Robbert G</creator><creator>van den Bijllaardt, Wouter</creator><creator>van Oudheusden, Anne J G</creator><creator>van Rijen, Miranda M L</creator><creator>Verweij, Jaco J</creator><creator>Koopmans, Marion P G</creator><creator>Kluytmans, Jan A J W</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200501</creationdate><title>Prevalence and Clinical Presentation of Health Care Workers With Symptoms of Coronavirus Disease 2019 in 2 Dutch Hospitals During an Early Phase of the Pandemic</title><author>Kluytmans-van den Bergh, Marjolein F Q ; Buiting, Anton G M ; Pas, Suzan D ; Bentvelsen, Robbert G ; van den Bijllaardt, Wouter ; van Oudheusden, Anne J G ; van Rijen, Miranda M L ; Verweij, Jaco J ; Koopmans, Marion P G ; Kluytmans, Jan A J W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a470t-7b65d61fdb9615f317e3340ccffe86e5a37c59ae07efd2509362fcd5c8c88a2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Betacoronavirus - isolation & purification</topic><topic>Community-Acquired Infections - epidemiology</topic><topic>Community-Acquired Infections - virology</topic><topic>Coronavirus Infections - epidemiology</topic><topic>Coronavirus Infections - virology</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - virology</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Fever</topic><topic>Health Personnel</topic><topic>Humans</topic><topic>Infectious Diseases</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Netherlands - epidemiology</topic><topic>Online Only</topic><topic>Original Investigation</topic><topic>Pandemics</topic><topic>Pneumonia, Viral - epidemiology</topic><topic>Pneumonia, Viral - virology</topic><topic>Prevalence</topic><topic>SARS-CoV-2</topic><topic>Self report</topic><topic>Severe acute respiratory syndrome</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Teaching hospitals</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kluytmans-van den Bergh, Marjolein F Q</creatorcontrib><creatorcontrib>Buiting, Anton G M</creatorcontrib><creatorcontrib>Pas, Suzan D</creatorcontrib><creatorcontrib>Bentvelsen, Robbert G</creatorcontrib><creatorcontrib>van den Bijllaardt, Wouter</creatorcontrib><creatorcontrib>van Oudheusden, Anne J G</creatorcontrib><creatorcontrib>van Rijen, Miranda M L</creatorcontrib><creatorcontrib>Verweij, Jaco J</creatorcontrib><creatorcontrib>Koopmans, Marion P G</creatorcontrib><creatorcontrib>Kluytmans, Jan A J W</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JAMA network open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kluytmans-van den Bergh, Marjolein F Q</au><au>Buiting, Anton G M</au><au>Pas, Suzan D</au><au>Bentvelsen, Robbert G</au><au>van den Bijllaardt, Wouter</au><au>van Oudheusden, Anne J G</au><au>van Rijen, Miranda M L</au><au>Verweij, Jaco J</au><au>Koopmans, Marion P G</au><au>Kluytmans, Jan A J W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and Clinical Presentation of Health Care Workers With Symptoms of Coronavirus Disease 2019 in 2 Dutch Hospitals During an Early Phase of the Pandemic</atitle><jtitle>JAMA network open</jtitle><addtitle>JAMA Netw Open</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>3</volume><issue>5</issue><spage>e209673</spage><epage>e209673</epage><pages>e209673-e209673</pages><issn>2574-3805</issn><eissn>2574-3805</eissn><abstract>On February 27, 2020, the first patient with coronavirus disease 2019 (COVID-19) was reported in the Netherlands. During the following weeks, at 2 Dutch teaching hospitals, 9 health care workers (HCWs) received a diagnosis of COVID-19, 8 of whom had no history of travel to China or northern Italy, raising the question of whether undetected community circulation was occurring.
To determine the prevalence and clinical presentation of COVID-19 among HCWs with self-reported fever or respiratory symptoms.
This cross-sectional study was performed in 2 teaching hospitals in the southern part of the Netherlands in March 2020, during the early phase of the COVID-19 pandemic. Health care workers employed in the participating hospitals who experienced fever or respiratory symptoms were asked to voluntarily participate in a screening for infection with the severe acute respiratory syndrome coronavirus 2. Data analysis was performed in March 2020.
The prevalence of severe acute respiratory syndrome coronavirus 2 infection was determined by semiquantitative real-time reverse transcriptase-polymerase chain reaction on oropharyngeal samples. Structured interviews were conducted to document symptoms for all HCWs with confirmed COVID-19.
Of 9705 HCWs employed (1722 male [18%]), 1353 (14%) reported fever or respiratory symptoms and were tested. Of those, 86 HCWs (6%) were infected with severe acute respiratory syndrome coronavirus 2 (median age, 49 years [range, 22-66 years]; 15 [17%] male), representing 1% of all HCWs employed. Most HCWs experienced mild disease, and only 46 (53%) reported fever. Eighty HCWs (93%) met a case definition of fever and/or coughing and/or shortness of breath. Only 3 (3%) of the HCWs identified through the screening had a history of travel to China or northern Italy, and 3 (3%) reported having been exposed to an inpatient with a known diagnosis of COVID-19 before the onset of symptoms.
Within 2 weeks after the first Dutch case was detected, a substantial proportion of HCWs with self-reported fever or respiratory symptoms were infected with severe acute respiratory syndrome coronavirus 2, likely as a result of acquisition of the virus in the community during the early phase of local spread. The high prevalence of mild clinical presentations, frequently not including fever, suggests that the currently recommended case definition for suspected COVID-19 should be used less stringently.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>32437576</pmid><doi>10.1001/jamanetworkopen.2020.9673</doi><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Betacoronavirus - isolation & purification Community-Acquired Infections - epidemiology Community-Acquired Infections - virology Coronavirus Infections - epidemiology Coronavirus Infections - virology Coronaviruses COVID-19 Cross Infection - epidemiology Cross Infection - virology Cross-Sectional Studies Female Fever Health Personnel Humans Infectious Diseases Male Middle Aged Netherlands - epidemiology Online Only Original Investigation Pandemics Pneumonia, Viral - epidemiology Pneumonia, Viral - virology Prevalence SARS-CoV-2 Self report Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Teaching hospitals Young Adult |
title | Prevalence and Clinical Presentation of Health Care Workers With Symptoms of Coronavirus Disease 2019 in 2 Dutch Hospitals During an Early Phase of the Pandemic |
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