Abstract
Purpose: This study aimed to compare the clinical characteristics, laboratory findings, and chest computed tomography (CT) findings of familial cluster (FC) and non-familial (NF) patients with coronavirus disease 2019 (COVID-19) pneumonia.Methods: This retrospective study included 178 symptomatic adult patients with laboratory-confirmed COVID-19. The 178 patients were divided into FC (n = 108) and NF (n = 70) groups. Patients with at least two confirmed COVID-19 cases in their household were classified into the FC group. The clinical and laboratory features between the two groups were compared and so were the chest CT findings on-admission and end-hospitalization.Results: Compared with the NF group, the FC group had a longer period of exposure (13.1 vs. 8.9 days, p < 0.001), viral shedding (21.5 vs. 15.9 days, p < 0.001), and hospital stay (39.2 vs. 22.2 days, p < 0.001). The FC group showed a higher number of involved lung lobes on admission (3.0 vs. 2.3, p = 0.017) and at end-hospitalization (3.6 vs. 1.7, p < 0.001) as well as higher sum severity CT scores at end-hospitalization (4.6 vs. 2.7, p = 0.005) than did the NF group. Conversely, the FC group had a lower lymphocyte count level (p < 0.001) and a significantly lower difference in the number of involved lung lobes (Δnumber) between admission and discharge (p < 0.001). Notably, more cases of severe or critical illness were observed in the FC group than in the NF group (p = 0.036).Conclusions: Patients in the FC group had a worse clinical course and outcome than those in the NF group; thus, close monitoring during treatment and follow-ups after discharge would be beneficial for patients with familial infections.
Highlights
In December 2019, the outbreak of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread rapidly, causing great concern worldwide
To the best of our knowledge, this is the first retrospective cohort study comparing the differences between familial cluster (FC) and NF groups of patients with COVID-19 pneumonia
CT evaluation indicated that the FC group showed a higher severity of lung abnormalities, whereas the NF group showed an improvement in the severity of lung opacities
Summary
In December 2019, the outbreak of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread rapidly, causing great concern worldwide. It was observed that familial transmission enables SARS-CoV-2 to spread faster and for infections to become more widespread. Other coronavirus family members, such as the Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS- CoV), cause diseases that mainly spread through non-socomial transmission. ∼43.5– 100% of these cases were related to transmission in hospitals, with MERS-CoV and SARS-CoV transmission within families accounting for only 13–21% and 22–39% of cases, respectively [6,7,8]. Studies suggest that in the familial spread of COVID-19, adults are more likely to present with symptoms than are children [11]
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