<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2183-8453</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Saúde Ocupacional online]]></journal-title>
<abbrev-journal-title><![CDATA[RPSO]]></abbrev-journal-title>
<issn>2183-8453</issn>
<publisher>
<publisher-name><![CDATA[Ajeogene Serviços Médicos Lda]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2183-84532020000200110</article-id>
<article-id pub-id-type="doi">10.31252/rpso.21.11.2020</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[A IMPORTÂNCIA DA PERSISTÊNCIA DIAGNÓSTICA NUM CASO SUSPEITO DE COVID-19 EM CONTEXTO OCUPACIONAL]]></article-title>
<article-title xml:lang="en"><![CDATA[THE IMPORTANCE OF DIAGNOSTIC PERSISTENCE IN A SUSPECTED CASE OF COVID-19 IN OCCUPATIONAL CONTEXT]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Afonso]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinheiro]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Antunes]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra  ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra  ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra  ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra  ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra  ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>jmrfos@gmail.com</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Coimbra</country>
</aff>
<pub-date pub-type="pub">
<day>31</day>
<month>12</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>31</day>
<month>12</month>
<year>2020</year>
</pub-date>
<volume>10</volume>
<fpage>110</fpage>
<lpage>116</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2183-84532020000200110&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2183-84532020000200110&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2183-84532020000200110&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO  Introdução A pandemia por SARS-CoV-2 veio trazer um novo e desafiante problema aos sistemas de saúde. Mais que nunca o rastreio e caracterização de cadeias de transmissão da doença tem-se revelado de extrema complexidade e importância. Como pilar fundamental deste rastreio está o diagnóstico sensível, específico e atempado dos casos suspeitos, que atualmente se baseia na deteção molecular de SARS-CoV-2 em amostras respiratórias. Esta estratégia pode ser insuficiente para um controlo efetivo da pandemia, uma vez que a performance diagnóstica da pesquisa varia ao longo do tempo pós exposição e está dependente da sensibilidade e especificidade dos testes utilizados.  Caso Clínico Relata-se um caso de um profissional de saúde com quadro clínico e epidemiológico (cronologica e geograficamente) altamente sugestivos de COVID-19 que, repetidamente, teve o resultado negativo na pesquisa molecular do agente da doença. A manutenção de queixas e imperiosidade de controlo de casos secundários, motivou o estudo mais detalhado com recurso a exames serológicos de imunoglobulinas específicas para SARS-CoV-2, que se revelaram reativos.  Discussão/Conclusão Destaca-se o papel primordial da suspeita clínica num cenário de pandemia e a necessidade de interpretação cuidada dos exames complementares de diagnóstico à luz da evolução da evidência científica. Releva-se ainda a importância da intervenção do Serviço de Saúde Ocupacional quer no que diz respeito não só ao diagnóstico, mas sobretudo no acompanhamento do caso, no sentido da promoção da saúde do profissional e da proteção dos restantes elementos da equipa e, implicitamente, dos doentes também.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction The SARS-CoV-2 pandemic has brought new and challenging problems to health care systems. More than ever, the screening and identification of disease transmission chains has proved to be extremely complex and important. The accurate diagnosis remains as a fundamental pillar of the screening, which is currently based on the molecular detection of SARS-CoV-2 in respiratory samples. This strategy may be insufficient for an effective control of the pandemic since the diagnostic performance of the molecular detection varies over time after exposure and is dependent on the sensitivity and specificity of the tests used.  Case Report A case report of a healthcare professional with a clinical and epidemiological context (chronologically and geographically) highly suggestive of COVID-19 who, repeatedly, had a negative result in the molecular search for the disease agent. The maintenance of complaints and imperiousness to control secondary cases, motivated the more detailed study using serological tests of specific immunoglobulins for SARS-CoV-2 that proved to be reactive.  Discussion/Conclusion The primary role of clinical suspicion in a pandemic scenario is highlighted and the need for careful interpretation of complementary diagnostic tests in the light of the evolution of scientific evidence. The intervention of the Occupational Health Service is also emphasized, both in terms of diagnosis and in monitoring the case in order to promote the health of the professional and to protect the remaining members of the healthcare staff and patients.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Pandemia]]></kwd>
<kwd lng="pt"><![CDATA[COVID-19]]></kwd>
<kwd lng="pt"><![CDATA[Diagnóstico COVID-19]]></kwd>
<kwd lng="pt"><![CDATA[RT-PCR]]></kwd>
<kwd lng="pt"><![CDATA[Imunologia]]></kwd>
<kwd lng="pt"><![CDATA[Saúde Ocupacional]]></kwd>
<kwd lng="pt"><![CDATA[Medicina do Trabalho]]></kwd>
<kwd lng="en"><![CDATA[Pandemic]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[COVID-19 Diagnosis]]></kwd>
<kwd lng="en"><![CDATA[RT-PCR]]></kwd>
<kwd lng="en"><![CDATA[Immunology]]></kwd>
<kwd lng="en"><![CDATA[Occupational Health]]></kwd>
</kwd-group>
</article-meta>
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