The informative experience of endocrine residents with COVID-19
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LETTER
The informative experience of endocrine residents with COVID‑19 M. Di Stefano1,2 · S. Federici1,2 · L. Giovanelli1,2 · B. Nadiani1,2 · F. Nicoli1,2 · M. Trevisan1,2 Received: 1 June 2020 / Accepted: 14 July 2020 © Italian Society of Endocrinology (SIE) 2020
Dear Editor, On February 26th 2020, 6 days after the detection of the index case of COVID-19 in Codogno, a small town 60 km from our hospital, we had a meeting with one supervisor, six postgraduate students (3F, 3M; age range: 25–27 years), one nurse (F, 43 years) and the head of the School of Endocrinology, University of Milan, to discuss the management of two clinical cases and assign the wards for the next couple of weeks. Two days after, 5/6 residents were affected with fever (37.7–38.2 °C) and variable flu-like manifestations (headache, weakness, myalgia, and sore throat). Following the national and regional indications, the affected participants were confined at home. One female reported gastrointestinal manifestations, another one reported mild chest pain, the third female had no additional symptoms and none reported cough or short breath. The manifestations lasted 1–4 days in the three females. Two nasopharyngeal swabs performed on two different days, 1 week after remission, were negative and they were readmitted to service. Conversely, 2 out of 3 males reported mild fever (37.1–37.5 °C) as main symptom, accompanied by weakness and headache for 2–3 days and both referred a delayed appearance of dysgeusia and anosmia that lasted another 10–14 days [1]. The nasopharyngeal swabs resulted positive for SARS-CoV-2 infection in both of them on five occasions at 1-week interval and the last one was obtained at 55 days after remission from mild manifestations. Two negative swabs were finally obtained 60–65 days after remission in both residents. Up-today, the remaining meeting participants were completely asymptomatic, but the swab resulted positive twice in the endocrine nurse at term of her quarantine period, 21–34 days after
* F. Nicoli [email protected] 1
Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy
2
the initial meeting. Thus, the SARS-CoV-2 infection can persist in the nasopharyngeal tract longer than previously reported in symptomatic patients after remission [2], but we are not aware of similar data in asymptomatic or paucisymptomatic subjects. The involvement of the cranial nerves for olfaction and taste, and male sex may associate with its long persistence. Since all subjects did not have any relation with the areas of epidemic outbreaks, this history is also consistent with a diffusion of the infection in northern Italy several weeks earlier than the detection of the index case [3]. SARS-CoV-2 infection would have diffused undetected among young adults (more likely to travel on public transports and attend crowded schools, events or clubs) because coexistent with the peak of
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