Clinical Factors, Preventive Behaviours and Temporal Outcomes Associated with COVID-19 Infection in Health Professionals at a Spanish Hospital

Abstract

The novel coronavirus disease (COVID-19) outbreak has quickly spread around the world, with Spain being one of the most severely affected countries. Healthcare professionals are an important risk group given their exposure. The aims of this study were to determine the prevalence of symptoms, main concerns as patients, preventive behaviours of healthcare professionals, and the different temporal outcomes associated with the negativization of PCR results. A total of 238 professionals were analysed and follow-up was conducted from 11 March to 21 April 2020 through clinical records, in-depth surveys, and telephone interviews. Symptoms, concerns, and preventive measures were documented, and temporal outcomes (start and end of symptoms, first positive PCR, and negativization of PCR) were analysed through survival analyses. A high prevalence of gastrointestinal symptoms (especially in women and older professionals), fever, cough, and fatigue were reported. The main concern was contagion in the work and home environment. Professionals (especially men) reported low use of face masks before the pandemic. Our analysis indicates that the median times for the negativization of PCR testing to confirm the resolution of infection is 15 days after the end of symptoms, or 25 days after the first positive PCR test. Our results suggest that these times are longer for women and for professionals aged ≥55 years, therefore follow-up strategies should be optimized in light of both variables. This is the first study we are aware of to report factors associated with the time to negativization of PCR results. We present the first rigorous estimates of time outcomes and hope that these data can be valuable to continue feeding the prediction models that are currently being developed. Similar studies are required to corroborate our results.

Gastroenterology manifestations and COVID‐19 outcomes: A meta‐analysis of 25,252 cohorts among the first and second waves

“…Systematic search as depicted in Figure 1A yield 125 eligible publications, including 25,252 participants 18–141 . Articles were published in 11 countries, predominated by China (101 studies; Figure 1B).…”

“…For pairwise comparisons, 60 articles compared the clinical data, laboratory features, and outcomes of COVID‐19 patients with and without GI symptoms (Table 2). 18,24,29,34,36,40,42–47,50,51,53,54,58,60,62,64,65,67,70,73,74,77,80,81,83,86,87,89,91–96,98,99,102,110,111,116–119,121–124,130,132,133,142 Of these, 26 studies compared severe/critical COVID‐19 patients versus mild cases, 18,34,43,44,46,47,51,53,62,67,70,73,74,77,92,93,98,99,102,111,117–119,121,122,133 four articles compared between hospitalized patients and those not required hospitalization, 45,80,89,142 five studies compared ICU admitted patients versus floor hospitalization, 50,80,96,116,142 11 publications compared between those who died with those who survived, 29,34,58,60,83,91,94,110,117,123,137 three articles reported the comparison between COVID‐19 patients with positive versus negative fecal shedding, 36,65,130 and of the remaining 14 studies comparing cohorts with and without GI symptoms 24,40,42,46,54,64,81,86,87,95,101,124,133,138 …”

COVID-19 gastrointestinal manifestations: a systematic review

“…A similar prevalence (10.3%) was reported by Cholankeril et al (2020) 51 in an American study that evaluated 116 patients. In this systematic review, the prevalence of diarrhea ranged from 2.8% 37 to 40.7% 43 among studies assessing general epidemiological and clinical characteristics of COVID-19 patients. On the other hand, the percentage of individuals who experienced symptoms varied from 5.95% 35 to 35.6% 54 in studies that only included patients with GI symptoms during SARS-CoV-2 infection.…”

Coronavirus Disease-2019 (COVID-19) and the Liver

“…The prevalence of GI and hepatic manifestations of COVID-19 is variable across studies from different regions, as highlighted in the data from meta-analyses (Table 1) [7][8][9][10][11][12][13] and individual studies ( Table 2). [14][15][16][17][18][19] In addition, endemic areas are associated with co-infections, such as acute viral hepatitis, and tropical infections, such as malaria and dengue. [20][21][22]…”