{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:53:46Z","timestamp":1784163226192,"version":"3.55.0"},"reference-count":14,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T00:00:00Z","timestamp":1606262400000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,11,14]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe a cohort of self-isolating healthcare workers (HCWs) with presumed COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional, single-centre study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A large, teaching hospital based in Central London with tertiary infection services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>236 HCWs completed a survey distributed by internal staff email bulletin. 167 were women and 65 men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Information on symptomatology, exposures and health-seeking behaviour were collected from participants by self-report.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 236 respondents reported illness compatible with COVID-19 and there was an increase in illness reporting during March 2020 Diagnostic swabs were not routinely performed. Cough (n=179, 75.8%), fever (n=138, 58.5%), breathlessness (n=84, 35.6%) were reported. Anosmia was reported in 42.2%. Fever generally settled within 1\u2009week (n=110\/138, 88%). Several respondents remained at home and did not seek formal medical attention despite reporting severe breathlessness and measuring hypoxia (n=5\/9, 55.6%). 2 patients required hospital admission but recovered following oxygen therapy. 84 respondents (41.2%) required greater than the obligated 7 days off work and 9 required greater than 3 weeks off.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There was a significant increase in staff reporting illness compatible with possible COVID-19 during March 2020. Subsequent serology studies at the same hospital study site have confirmed sero-positivity for COVID-19 up to 45% by the end of April 2020 in frontline HCWs. The study revealed a concerning lack of healthcare seeking in respondents with significant red flag symptoms (severe breathlessness, hypoxia). This study also highlighted anosmia as a key symptom of COVID-19 early in the pandemic, prior to this symptom being more widely recognised as a feature of COVID-19.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-040216","type":"journal-article","created":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T15:37:53Z","timestamp":1606405073000},"page":"e040216","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Delayed healthcare seeking and prolonged illness in healthcare workers during the COVID-19 pandemic: a single-centre observational study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3363-8372","authenticated-orcid":false,"given":"Angus","family":"de Wilton","sequence":"first","affiliation":[{"name":"COVID-19 Response Team, Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, Hospital for Tropical Diseases, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliz","family":"Kilich","sequence":"additional","affiliation":[{"name":"COVID-19 Response Team, Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, Hospital for Tropical Diseases, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zain","family":"Chaudhry","sequence":"additional","affiliation":[{"name":"COVID-19 Response Team, Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, Hospital for Tropical Diseases, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy CK","family":"Bell","sequence":"additional","affiliation":[{"name":"COVID-19 Response Team, Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, Hospital for Tropical Diseases, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Gahir","sequence":"additional","affiliation":[{"name":"COVID-19 Response Team, Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, Hospital for Tropical Diseases, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Cadman","sequence":"additional","affiliation":[{"name":"Occupational Health, COVID-19 Response Team, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A","family":"Lever","sequence":"additional","affiliation":[{"name":"COVID-19 Response Team, Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, Hospital for Tropical Diseases, London, UK"},{"name":"Division of Infection and Immunity, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A","family":"Logan","sequence":"additional","affiliation":[{"name":"COVID-19 Response Team, Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, Hospital for Tropical Diseases, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,11,26]]},"reference":[{"key":"2025101813280090000_10.11.e040216.1","unstructured":"Public Health England . Guidance on social distancing for everyone in the UK. GOV. UK, 2020. Available: https:\/\/www.gov.uk\/government\/publications\/covid-19-guidance-on-social-distancing-and-for-vulnerable-people\/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults [Accessed 14 Apr 2020]."},{"key":"2025101813280090000_10.11.e040216.2","unstructured":"Houlihan C , Vora N , Byrne T , et al . Pandemic peak SARS-CoV-2 infection and seroconversion rates in London frontline health-care workers, 2020. Available: https:\/\/www.thelancet.com\/pdfs\/journals\/lancet\/PIIS0140-6736(20)31484-7.pdf [Accessed 9 Sep 2020]."},{"key":"2025101813280090000_10.11.e040216.3","unstructured":"SARS-CoV-2 viral . load and the severity of COVID-19 - CEBM, 2020. Available: https:\/\/www.cebm.net\/covid-19\/sars-cov-2-viral-load-and-the-severity-of-covid-19\/ [Accessed 14 Apr 2020]."},{"key":"2025101813280090000_10.11.e040216.4","unstructured":"England PH . COVID-19: management of exposed healthcare workers and patients in hospital settings. GOV. UK, 2020. Available: https:\/\/www.gov.uk\/government\/publications\/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings\/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings [Accessed 14 Apr 2020]."},{"key":"2025101813280090000_10.11.e040216.5","unstructured":"England PH . Stay at home: guidance for households with possible coronavirus (COVID-19) infection. GOV. UK, 2020. Available: https:\/\/www.gov.uk\/government\/publications\/covid-19-stay-at-home-guidance\/stay-at-home-guidance-for-households-with-possible-coronavirus-covid-19-infection [Accessed 28 Apr 2020]."},{"key":"2025101813280090000_10.11.e040216.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"2025101813280090000_10.11.e040216.7","article-title":"A comparative-descriptive analysis of clinical characteristics in 2019-coronavirus-infected children and adults","author":"Han","year":"2020","journal-title":"J Med Virol"},{"key":"2025101813280090000_10.11.e040216.8","unstructured":"Kluytmans M , Buiting A , Pas S , et al . SARS-CoV-2 infection in 86 healthcare workers in two Dutch hospitals in March 2020. 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Available: https:\/\/bioinfogp.cnb.csic.es\/tools\/venny\/ [Accessed 28 Apr 2020]."},{"key":"2025101813280090000_10.11.e040216.12","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2164-9-488"},{"key":"2025101813280090000_10.11.e040216.13","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/S1473-3099(20)30297-8","article-title":"Utility of hyposmia and hypogeusia for the diagnosis of COVID-19","volume":"20","author":"B\u00e9n\u00e9zit","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"2025101813280090000_10.11.e040216.14","doi-asserted-by":"crossref","DOI":"10.1001\/jamaneurol.2020.1127","article-title":"Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China","volume":"77","author":"Mao","year":"2020","journal-title":"JAMA Neurol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-040216","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:28:16Z","timestamp":1760819296000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-040216"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":14,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11,26]]},"published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1136\/bmjopen-2020-040216"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-040216","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.05.07.20094177","asserted-by":"object"}]},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11]]}}}