Introduction
Health personnel, including physicians, are a fundamental part of the first line of defense against the SARS-CoV-2 pandemic.

Objective
To characterize the clinical manifestations and course of the first cases of contagion by SARS-CoV-2 in doctors of Peru.

Methodology
We present a series of six cases of doctors infected by SARS-CoV-2, with confirmed positivity for COVID-19, showing the daily evolution from the diagnosis of the disease, its main signs and symptoms, evolution, and until the outcome in each case.

Results
Five were men. The median age was 28 years (interquartile range: 27 to 33). In three cases the physician worked more than 12 hours a day in emergency and hospitalization services and not wear a mask at all times. The most frequent symptoms were axillary temperature above 38°C, malaise, dry cough, and odynophagia (the latter in three of the cases). The diagnosis was made at a median of 3 days (interquartile range: 3 to 4 days). The symptoms that persisted the most were dry cough (present during ten days in four doctors). Dysgeusia was the only symptom with the most extended duration (15 days in only one doctor). In the six cases, the course was favorable. However, these doctors found it difficult to return to functions in their hospital centers adequately.

Discussion
Despite a small number of cases, it is the first report detailing the evolution of symptoms day by day, which can help for occupational health and even for case surveillance and monitoring.

Authors: Martín A. Vilela-Estrada[1], Irwing R. Benites-Flores[2], Mario B. García-Saavedra[2,3], Christian R. Mejia[4]

Affiliation:
[1] Facultad de Medicina Humana, Universidad Privada Antenor Orrego, Trujillo, Perú
[2] Escuela de Posgrado, Universidad Nacional Mayor de San Marcos, Lima, Perú
[3] Departamento de Cardiología, Hospital Nacional Daniel Alcides Carrión, Callao, Perú
[4] Universidad Continental, Lima, Perú

E-mail: christian.mejia.md@gmail.com

Author address:
[1] Av. Las Palmeras 5713, Los Olivos
Lima, Perú
Código Postal: 15304

Citation: Vilela-Estrada MA, Benites-Flores IR, García-Saavedra MB, Mejia CR. Clinical manifestations and course of the first six reported cases of COVID-19 in the medical doctors of Peru. Medwave 2020;20(7):e7994 doi: 10.5867/medwave.2020.07.7994

Submission date: 11/4/2020

Acceptance date: 11/7/2020

Publication date: 13/8/2020

Origin: Not commissioned.

Type of review: Externally peer-reviewed by four reviewers, double-blind.

Comments (0)

We are pleased to have your comment on one of our articles. Your comment will be published as soon as it is posted. However, Medwave reserves the right to remove it later if the editors consider your comment to be: offensive in some sense, irrelevant, trivial, contains grammatical mistakes, contains political harangues, appears to be advertising, contains data from a particular person or suggests the need for changes in practice in terms of diagnostic, preventive or therapeutic interventions, if that evidence has not previously been published in a peer-reviewed journal.

No comments on this article.

---

To comment please log in

Medwave provides HTML and PDF download counts as well as other harvested interaction metrics.

There may be a 48-hour delay for most recent metrics to be posted.

1. Zhu H, Wei L, Niu P. The novel coronavirus outbreak in Wuhan, China. Glob Health Res Policy. 2020;5(1):2-3. | CrossRef | PubMed |
2. WHO. Novel Coronavirus – China. World Health Organization; [citado 8 de abril de 2020]. [Internet] | Link |
3. WHO. Pneumonia of unknown cause – China. World Health Organization; [citado 8 de abril de 2020]. [Internet] | Link |
4. WHO. National capacities review tool for a novel coronavirus (nCoV). World Health Organization. 2020 [citado 8 de abril de 2020]. [Internet] | Link |
5. WHO. Situation report - 1 on Novel Coronavirus. World Health Organization. 2020 [citado 8 de abril de 2020]. [Internet] | Link |
6. WHO. Situation report - 16 on Novel Coronavirus (COVID - 19). World Health Organization. 2020. [citado 8 de abril de 2020]. [Internet] | Link |
7. WHO. Situation report - 49 on Novel Coronavirus (COVID - 19). World Health Organization. 2020. [Internet] | Link |
8. OPS, OMS. OPS emite alerta epidemiológica sobre nuevo coronavirus. Pan American Health Organization / World Health Organization. [citado 8 de abril de 2020]. [Internet] | Link |
9. DW. México analiza otros ocho posibles casos de coronavirus. Deutsche Welle. 2020. [citado 8 de abril de 2020]. [Internet] | Link |
10. Clarín. Coronavirus en Argentina: descartan el caso de Capital y quedan 10 sospechosos en estudio. Clarín. [citado 8 de abril de 2020]. [Internet] | Link |
11. Johns Hopkins University & Medicine. Coronavirus Resource Center. Johns Hopkins University & Medicine. [citado 8 de abril de 2020]. [Internet] | Link |
12. MINSA. Sala Situacional COVID-19 Perú. Ministerio de Salud Perú. [citado 8 de abril de 2020]. [Internet] | Link |
13. El Peruano. Decreto de urgencia Nº 026-2020, decreto de urgencia que establece diversas medidas excepcionales y temporales para prevenir la propagación del coronavirus (COVID-19) en el territorio nacional. El Peruano [citado 8 de abril de 2020]. [Internet] | Link |
14. Canal N. Colegio Médico: Existen 31 médicos aislados por sospecha de coronavirus. Canal N. [citado 8 de abril de 2020]. [Internet] | Link |
15. MINSA. Documento Técnico Atención y manejo clínico de casos de COVID-19, Escenario de Transmisión Focalizada. Ministerio de Salud Perú. [citado 8 de abril de 2020]. [Internet] | Link |
16. OPS, OMS. Documentos técnicos - Enfermedad por coronavirus (COVID-19). Organización Panamericana de la Salud. [citado 8 de abril de 2020]. [Internet] | Link |
17. Zhan S, Yang YY, Fu C. Public’s early response to the novel coronavirus-infected pneumonia. Emerg Microbes Infect. 2020;9(1):534. | CrossRef |
18. Cheng JL, Huang C, Zhang GJ, Liu DW, Li P, Lu CY, et al. Epidemiological characteristics of novel coronavirus pneumonia in Henan. Zhonghua Jie He He Hu Xi Za Zhi Zhonghua Jiehe He Huxi Zazhi Chin J Tuberc Respir Dis. 2020;43(0):E027. | CrossRef | PubMed |
19. Tian S, Hu N, Lou J, Chen K, Kang X, Xiang Z, et al. Characteristics of COVID-19 infection in Beijing. J Infect. 2020;80(4):401-6. | CrossRef | PubMed |
20. Wu Z, McGoogan J. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13): 1239-1242. | CrossRef | PubMed |
21. Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation and Treatment Coronavirus (COVID-19). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020 Jan. [Updated 2020 Abril 8]. [Internet] | Link |
22. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395: 497–506. | CrossRef |
23. Pongpirul WA, Pongpirul K, Ratnarathon A, Prasithsirikul W. Journey of a Thai Taxi Driver and Novel Coronavirus. N Engl J Med. 2020; 382:1067-1068. | CrossRef | PubMed |
24. Keyhan SO, Fallahi HR, Cheshmi B. Dysosmia and dysgeusia due to the 2019 Novel Coronavirus; a hypothesis that needs further investigation. Version 2. Maxillofac Plast Reconstr Surg. 2020; 30;42(1):9. | CrossRef |
25. Radio Farda. Loss of sense of smell among Iranians coinciding with Coronavirus epidemic. Radio Farda. [citado 8 de abril de 2020]. [Internet] | Link |
26. IFP Editorial staff. Olfactory disorder getting prevalent in Iran amid Coronavirus outbreak. ifpnews. [citado 8 de abril de 2020]. [Internet] | Link |
27. Keyhan SO, Fallahi HR, Cheshmi B. Dysosmia and dysgeusia due to the 2019 Novel Coronavirus; a hypothesis that needs further investigation. Maxillofacial Plastic and Reconstructive Surgery. 2020; 42(9):1-2. | CrossRef |
28. República del Perú, Resolución Ministerial N° 139-2020-MINSA. Documento Técnico Prevención y Atención de personas afectadas por COVID-19. [citado 8 de abril de 2020]. [Internet] | Link |
29. OMS, OPS. Actualización Epidemiológica: Nuevo coronavirus (COVID-19). Organización Panamericana de la Salud / Organización Mundial de la Salud. 14 de febrero de 2020. [Internet] | Link |
30. Ng K, Poon BH, Kiat Puar TH, Shan Quah JL, Loh WJ, Wong YJ, et al. COVID-19 and the Risk to Health Care Workers: A Case Report. Ann Intern Med. 2020 Jun 2;172(11):766-767. | CrossRef | PubMed |
31. Bhagavathula AS, Aldhaleei WA, Rahmani J, Mahabadi MA, Bandari DK. Knowledge and Perceptions of COVID-19 Among Health Care Workers: Cross-Sectional Study. JMIR Public Health Surveill. 2020 Apr 30;6(2):e19160. | CrossRef | PubMed |
32. Hussin A. Rothan, Siddappa N. Byrareddy. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of Autoimmunity. 2020; 109(1):41-44. | CrossRef | PubMed |
33. Yang W, Cao Q, Qin L, Wang X, Cheng Z, Pan A, et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China. J Infect. 2020 Apr;80(4):388-393. | CrossRef | PubMed |
34. El Peruano. La OPS alerta sobre la rápida expansión del coronavirus en América. El Peruano. [citado 8 de abril de 2020]. [Internet] | Link |

Zhu H, Wei L, Niu P. The novel coronavirus outbreak in Wuhan, China. Glob Health Res Policy. 2020;5(1):2-3. | CrossRef | PubMed |

WHO. Novel Coronavirus – China. World Health Organization; [citado 8 de abril de 2020]. [Internet] | Link |

WHO. Pneumonia of unknown cause – China. World Health Organization; [citado 8 de abril de 2020]. [Internet] | Link |

WHO. National capacities review tool for a novel coronavirus (nCoV). World Health Organization. 2020 [citado 8 de abril de 2020]. [Internet] | Link |

WHO. Situation report - 1 on Novel Coronavirus. World Health Organization. 2020 [citado 8 de abril de 2020]. [Internet] | Link |

WHO. Situation report - 16 on Novel Coronavirus (COVID - 19). World Health Organization. 2020. [citado 8 de abril de 2020]. [Internet] | Link |

WHO. Situation report - 49 on Novel Coronavirus (COVID - 19). World Health Organization. 2020. [Internet] | Link |

OPS, OMS. OPS emite alerta epidemiológica sobre nuevo coronavirus. Pan American Health Organization / World Health Organization. [citado 8 de abril de 2020]. [Internet] | Link |

DW. México analiza otros ocho posibles casos de coronavirus. Deutsche Welle. 2020. [citado 8 de abril de 2020]. [Internet] | Link |

Clarín. Coronavirus en Argentina: descartan el caso de Capital y quedan 10 sospechosos en estudio. Clarín. [citado 8 de abril de 2020]. [Internet] | Link |

Johns Hopkins University & Medicine. Coronavirus Resource Center. Johns Hopkins University & Medicine. [citado 8 de abril de 2020]. [Internet] | Link |

MINSA. Sala Situacional COVID-19 Perú. Ministerio de Salud Perú. [citado 8 de abril de 2020]. [Internet] | Link |

El Peruano. Decreto de urgencia Nº 026-2020, decreto de urgencia que establece diversas medidas excepcionales y temporales para prevenir la propagación del coronavirus (COVID-19) en el territorio nacional. El Peruano [citado 8 de abril de 2020]. [Internet] | Link |

Canal N. Colegio Médico: Existen 31 médicos aislados por sospecha de coronavirus. Canal N. [citado 8 de abril de 2020]. [Internet] | Link |

MINSA. Documento Técnico Atención y manejo clínico de casos de COVID-19, Escenario de Transmisión Focalizada. Ministerio de Salud Perú. [citado 8 de abril de 2020]. [Internet] | Link |

OPS, OMS. Documentos técnicos - Enfermedad por coronavirus (COVID-19). Organización Panamericana de la Salud. [citado 8 de abril de 2020]. [Internet] | Link |

Zhan S, Yang YY, Fu C. Public’s early response to the novel coronavirus-infected pneumonia. Emerg Microbes Infect. 2020;9(1):534. | CrossRef |

Cheng JL, Huang C, Zhang GJ, Liu DW, Li P, Lu CY, et al. Epidemiological characteristics of novel coronavirus pneumonia in Henan. Zhonghua Jie He He Hu Xi Za Zhi Zhonghua Jiehe He Huxi Zazhi Chin J Tuberc Respir Dis. 2020;43(0):E027. | CrossRef | PubMed |

Tian S, Hu N, Lou J, Chen K, Kang X, Xiang Z, et al. Characteristics of COVID-19 infection in Beijing. J Infect. 2020;80(4):401-6. | CrossRef | PubMed |

Wu Z, McGoogan J. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323(13): 1239-1242. | CrossRef | PubMed |

Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation and Treatment Coronavirus (COVID-19). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020 Jan. [Updated 2020 Abril 8]. [Internet] | Link |

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395: 497–506. | CrossRef |

Pongpirul WA, Pongpirul K, Ratnarathon A, Prasithsirikul W. Journey of a Thai Taxi Driver and Novel Coronavirus. N Engl J Med. 2020; 382:1067-1068. | CrossRef | PubMed |

Keyhan SO, Fallahi HR, Cheshmi B. Dysosmia and dysgeusia due to the 2019 Novel Coronavirus; a hypothesis that needs further investigation. Version 2. Maxillofac Plast Reconstr Surg. 2020; 30;42(1):9. | CrossRef |

Radio Farda. Loss of sense of smell among Iranians coinciding with Coronavirus epidemic. Radio Farda. [citado 8 de abril de 2020]. [Internet] | Link |

IFP Editorial staff. Olfactory disorder getting prevalent in Iran amid Coronavirus outbreak. ifpnews. [citado 8 de abril de 2020]. [Internet] | Link |

Keyhan SO, Fallahi HR, Cheshmi B. Dysosmia and dysgeusia due to the 2019 Novel Coronavirus; a hypothesis that needs further investigation. Maxillofacial Plastic and Reconstructive Surgery. 2020; 42(9):1-2. | CrossRef |

República del Perú, Resolución Ministerial N° 139-2020-MINSA. Documento Técnico Prevención y Atención de personas afectadas por COVID-19. [citado 8 de abril de 2020]. [Internet] | Link |

OMS, OPS. Actualización Epidemiológica: Nuevo coronavirus (COVID-19). Organización Panamericana de la Salud / Organización Mundial de la Salud. 14 de febrero de 2020. [Internet] | Link |

Ng K, Poon BH, Kiat Puar TH, Shan Quah JL, Loh WJ, Wong YJ, et al. COVID-19 and the Risk to Health Care Workers: A Case Report. Ann Intern Med. 2020 Jun 2;172(11):766-767. | CrossRef | PubMed |

Bhagavathula AS, Aldhaleei WA, Rahmani J, Mahabadi MA, Bandari DK. Knowledge and Perceptions of COVID-19 Among Health Care Workers: Cross-Sectional Study. JMIR Public Health Surveill. 2020 Apr 30;6(2):e19160. | CrossRef | PubMed |

Hussin A. Rothan, Siddappa N. Byrareddy. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of Autoimmunity. 2020; 109(1):41-44. | CrossRef | PubMed |

Yang W, Cao Q, Qin L, Wang X, Cheng Z, Pan A, et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China. J Infect. 2020 Apr;80(4):388-393. | CrossRef | PubMed |

El Peruano. La OPS alerta sobre la rápida expansión del coronavirus en América. El Peruano. [citado 8 de abril de 2020]. [Internet] | Link |