scholarly journals A familial cluster of coronavirus disease 2019 (COVID-19) caused by one family member during his asymptomatic incubation period

2020 ◽  
Vol 42 (3) ◽  
pp. 656-658
Author(s):  
Hao Sang ◽  
Yan Cui ◽  
Xiaobin Lai ◽  
Yuyan Zhang ◽  
Lingna Kong ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Family Member ◽  
Incubation Period ◽  
Clinical Symptoms ◽  
Close Contact ◽  
Critical Role ◽  
Asymptomatic Infection ◽  
Nucleic Acid Detection ◽  
Familial Cluster ◽  
Enclosed Space

Abstract An ongoing outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread in the world, whereas asymptomatic carriers may also play a critical role in the pandemic. We report a familial cluster of COVID-19 caused by one family member before his onset of illness, indicating that it seems to be potentially infectious during the incubation period, even earlier than we expected. Close contact, especially in a small enclosed space, might be the cause of familial transmission. The unsynchronized changes in the clinical symptoms and COVID-19 nucleic acid were found in this case, so consecutive nucleic acid detection of pretty suspected cases was recommended. Family members, especially of whom the confirmed cases contacted with since one incubation period before onset rather than 2 days before onset, should be regarded as close contact and centrally isolated in case of asymptomatic infection already existed in the family.

The application of viral nucleic acid detection and lung CT in COVID-19 diagnosis

2020 ◽  
Author(s):  
Rui Hu
Keyword(s):  
Nucleic Acid ◽  
Clinical Symptoms ◽  
Virus Disease ◽  
False Negative ◽  
False Negative Rate ◽  
Diagnostic Methods ◽  
Nucleic Acid Detection ◽  
Viral Nucleic Acid ◽  
Early Medical Intervention ◽  
Lung Ct

The Corona Virus Disease 2019 (COVID-19) has the characteristics of fast propagation speed and strong pathogenicity and has attracted wide attention of people, medical workers, and researchers around the world. Accurate, rapid, and timely screening and diagnosis of COVID-19 is of great significance to control the development of the epidemic situation and save the lives of patients. Currently, the detection of viral nucleic acid and lung CT is the main screening and diagnostic methods of COVID-19. Nucleic acid detection has the advantages of fast, strong specificity and high sensitivity, but there is a certain false-negative rate. CT result of lung examination is visual, but it is not typical due to the uncertain time of clinical symptoms and the early medical intervention. Therefore, the diagnosis of COVID-19 should include a combination of epidemiological history, clinical symptoms, imaging, and laboratory tests.

scholarly journals A follow-up study of children infected with SARS-CoV-2 from Western China

2020 ◽  
Author(s):  
Hongmei Xu ◽  
Enmei Liu ◽  
Jun Xie ◽  
Rosalind Smyth ◽  
Qi Zhou ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Ct Scan ◽  
Negative Correlation ◽  
Clinical Symptoms ◽  
White Blood Cells ◽  
Pediatric Intensive Care ◽  
Significant Negative Correlation ◽  
Asymptomatic Infection ◽  
Western China ◽  
Asymptomatic Children

AbstractBackgroundTo clarify the characteristic and the duration of positive nucleic acid in children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including asymptomatic children.MethodsA total of 32 children confirmed with SARS-CoV-2 infection between January 24 and February 12, 2020 from four provinces in Western China were enrolled in this study and followed up until discharge and quarantine 14 days later.ResultsEleven children (34%) were asymptomatic, among whom six children had normal computed tomographic (CT) scan images. Age and gender were not associated with clinical symptoms or the results of CT scan in children infected with SARS-CoV-2. The concentrations of white blood cells and neutrophils were higher in children with asymptomatic infection than in children with clinical symptoms or CT abnormalities. Patients who presented with CT abnormalities had lower D-dimer or lower total bilirubin than those who had normal CT scan but clinical symptoms. All children recovered and no one died or was admitted to the pediatric intensive care unit (PICU). The mean duration of positive SARS-CoV-2 nucleic acid was 15.4 (SD=7.2) days and similar for both asymptomatic children and children with symptoms or CT abnormalities. We found a significant negative correlation between the lymphocyte count and the duration of positive nucleic acid test.ConclusionsChildren with asymptomatic infection should be quarantined for the same duration as symptomatic patients infected with SARS-CoV-2. The clinical significance and mechanism behind the negative correlation between the number of lymphocytes and the duration of positive SARS-CoV-2 needs further study.

scholarly journals Epidemiological analysis of 67 local COVID-19 clusters in Sichuan Province, China

2020 ◽  
Author(s):  
Suling Mao ◽  
Ting Huang ◽  
Heng Yuan ◽  
Min Li ◽  
Xiaomei Huang ◽  
...  
Keyword(s):  
Incubation Period ◽  
Attack Rate ◽  
Clinical Symptoms ◽  
Close Contact ◽  
Sichuan Province ◽  
Information Support ◽  
Protective Effects ◽  
Systemic Symptoms ◽  
And Control ◽  
Epidemiological Characteristics

Abstract Background This study was intended to investigate the epidemiological characteristics of COVID-19 clusters and the severity distribution of clinical symptoms of involved cases in Sichuan Province, so as to provide information support for the development and adjustment of strategies for the prevention and control of local clusters.Methods The epidemiological characteristics of 67 local clusters of COVID-19 cases in Sichuan Province reported as of March 17, 2020 were described and analyzed. Information about all COVID-19 clusters and involved cases was acquired from the China Information System for Disease Control and Prevention and analyzed with the epidemiological investigation results taken into account.Results The clusters were temporally and regionally concentrated. Clusters caused by imported cases from Wuhan and other provinces except Wuhan accounted for 73.13%; familial clusters accounted for 68.66%; the average attack rate was 8.54%, and the average secondary attack rate was 6.11%; the median incubation period was 8.5 d;a total of 28 cases met the criteria for incubation period determination, and in the 28 cases, the incubation period was > 14 d in 21.43% (6/28). a total of 226 confirmed cases were reported in the 67 clusters. Ten cases were exposed before the confirmed cases they contacted with developed clinical symptoms, and the possibility of exposure to other infection sources was ruled out; two clusters were caused by asymptomatic carriers; confirmed cases mainly presented with fever, respiratory and systemic symptoms; a gradual decline in the severity of clinical symptoms was noted with the increase of the case generation.Conclusions Population movement and gathering restrictions and strict close contact management measures will significantly contribute to the identification and control of cases. Transmission during the incubation period and asymptomatic infections have been noted. Studies on the pathogenicity and transmissibility in these populations and on COVID-19 antibody levels and protective effects in healthy people and cases are required.

scholarly journals A case of SARS-CoV-2 carrier for 32 days with several times false negative nucleic acid tests

2020 ◽  
Author(s):  
Lingjie Song ◽  
Guibao Xiao ◽  
Xianqin Zhang ◽  
Zhan Gao ◽  
Shixia Sun ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Antiviral Treatment ◽  
Immune Therapy ◽  
False Negative ◽  
Clinical Manifestations ◽  
Nucleic Acid Detection ◽  
Rt Pcr ◽  
Nucleic Acid Tests

AbstractIn 2019, a novel coronavirus (SARS-CoV-2) was first discovered in Wuhan, Hubei, China, causing severe respiratory disease in humans, and has been identified as a public health emergency of international concern. With the spread of the virus, there are more and more false negative cases of RT-PCR nucleic acid detection in the early stage of potential infection. In this paper, we collected the epidemiological history, clinical manifestations, outcomes, laboratory results and images of a SARS-CoV-2 carrier with no significant past medical history. The patient was quarantined because of her colleague had been diagnosed. After the onset of clinical symptoms, chest CT results showed patchy ground-glass opacity (GGO) in her lungs, but it took a total of nine nucleic acid tests to confirm the diagnosis, among which the first eight RT-PCR results were negative or single-target positive. In addition to coughing up phlegm during her stay in the hospital, she did not develop chills, fever, abdominal pain, diarrhea and other clinical symptoms. Since initial antiviral treatment, the lung lesions were absorbed. But the sputum nucleic acid test was still positive. In combination with antiviral and immune therapy, the patient tested negative for the virus. Notably, SARS-CoV-2 was detected only in the lower respiratory tract samples (sputum) throughout the diagnosis and treatment period. This is a confirmed case of SARS-CoV-2 infection with common symptoms, and her diagnosis has undergone multiple false negatives, suggesting that it is difficult to identify certain carriers of the virus and that such patients may also increase the spread of the SARS-CoV-2.

scholarly journals Analysis and Prediction of COVID-19 Patients’ False Negative Results for SARS-CoV-2 Detection with Pharyngeal Swab Specimen: A Retrospective Study

2020 ◽  
Author(s):  
Hui Xu ◽  
Li Yan ◽  
Chun (Martin) Qiu ◽  
Bo Jiao ◽  
Yanyan Chen ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Time Window ◽  
Clinical Symptoms ◽  
False Negative ◽  
Ct Imaging ◽  
Nucleic Acid Detection ◽  
False Negatives ◽  
Negative Results ◽  
False Negative Results ◽  
Blood Routine

ABSTRACTBackgroundFalse negative results of SARS-CoV-2 nucleic acid detection pose threats to COVID-19 patients and medical workers alike.ObjectiveTo develop multivariate models to determine clinical characteristics that contribute to false negative results of SARS-CoV-2 nucleic acid detection, and use them to predict false negative results as well as time windows for testing positive.DesignRetrospective Cohort Study (Ethics number of Tongji Hospital: No. IRBID: TJ-20200320)SettingA database of outpatients in Tongji Hospital (University Hospital) from 15 January 2020 to 19 February 2020.Patients1,324 outpatients with COVID-19MeasurementsClinical information on CT imaging reports, blood routine tests, and clinic symptoms were collected. A multivariate logistic regression was used to explain and predict false negative testing results of SARS-CoV-2 detection. A multivariate accelerated failure model was used to analyze and predict delayed time windows for testing positive.ResultsOf the 1,324 outpatients who diagnosed of COVID-19, 633 patients tested positive in their first SARS-CoV-2 nucleic acid test (47.8%), with a mean age of 51 years (SD=14.9); the rest, which had a mean age of 47 years (SD=15.4), tested negative in the first test. “Ground glass opacity” in a CT imaging report was associated with a lower chance of false negatives (aOR, 0.56), and reduced the length of time window for testing positive by 26%. “Consolidation” was associated with a higher chance of false negatives (aOR, 1.57), and extended the length of time window for testing positive by 44%. In blood routine tests, basophils (aOR, 1.28) and eosinophils (aOR, 1.29) were associated with a higher chance of false negatives, and were found to extend the time window for testing positive by 23% and 41%, respectively. Age and gender also affected the significantly.LimitationData were generated in a large single-center study.ConclusionTesting outcome and positive window of SARS-CoV-2 detection for COVID-19 patients were associated with CT imaging results, blood routine tests, and clinical symptoms. Taking into account relevant information in CT imaging reports, blood routine tests, and clinical symptoms helped reduce a false negative testing outcome. The predictive AFT model, what we believe to be one of the first statistical models for predicting time window of SARS-CoV-2 detection, could help clinicians improve the accuracy and efficiency of the diagnosis, and hence, optimizes the timing of nucleic acid detection and alleviates the shortage of nucleic acid detection kits around the world.Primary Funding SourceNone.

scholarly journals Epidemiological analysis of 67 local COVID-19 clusters in Sichuan Province, China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Suling Mao ◽  
Ting Huang ◽  
Heng Yuan ◽  
Min Li ◽  
Xiaomei Huang ◽  
...  
Keyword(s):  
Incubation Period ◽  
Attack Rate ◽  
Clinical Symptoms ◽  
Close Contact ◽  
Sichuan Province ◽  
Information Support ◽  
Protective Effects ◽  
Systemic Symptoms ◽  
And Control ◽  
Epidemiological Characteristics

Abstract Background This study was intended to investigate the epidemiological characteristics of COVID-19 clusters and the severity distribution of clinical symptoms of involved cases in Sichuan Province, so as to provide information support for the development and adjustment of strategies for the prevention and control of local clusters. Methods The epidemiological characteristics of 67 local clusters of COVID-19 cases in Sichuan Province reported as of March 17, 2020 were described and analyzed. Information about all COVID-19 clusters and involved cases was acquired from the China Information System for Disease Control and Prevention and analyzed with the epidemiological investigation results taken into account. Results The clusters were temporally and regionally concentrated. Clusters caused by imported cases from other provinces accounted for 73.13%; familial clusters accounted for 68.66%; the average attack rate was 8.54%, and the average secondary attack rate was 6.11%; the median incubation period was 8.5 d; a total of 28 cases met the criteria for incubation period determination, and in the 28 cases, the incubation period was > 14 d in 21.43% (6/28). a total of 226 confirmed cases were reported in the 67 clusters. Ten cases were exposed before the confirmed cases they contacted with developed clinical symptoms, and the possibility of exposure to other infection sources was ruled out; two clusters were caused by asymptomatic carriers; confirmed cases mainly presented with fever, respiratory and systemic symptoms; a gradual decline in the severity of clinical symptoms was noted with the increase of the case generation. Conclusions Population movement and gathering restrictions and strict close contact management measures will significantly contribute to the identification and control of cases. Transmission during the incubation period and asymptomatic infections have been noted. Studies on the pathogenicity and transmissibility in these populations and on COVID-19 antibody levels and protective effects in healthy people and cases are required.

scholarly journals Epidemiological Characteristics of COVID-19 in Seremban, Negeri Sembilan, Malaysia

2020 ◽  
Vol 8 (T1) ◽  
pp. 471-475
Author(s):  
Mohd ‘Ammar Ihsan Ahmad Zamzuri ◽  
Farah Edura Ibrahim ◽  
Muhammad Alimin Mat Reffien ◽  
Mohd Fathulzhafran Mohamed Hanan ◽  
Muhamad Hazizi Muhamad Dasani ◽  
...  
Keyword(s):  
Local Community ◽  
Clinical Symptoms ◽  
Early Recognition ◽  
Close Contact ◽  
Intervention Strategy ◽  
Cross Sectional Study ◽  
Asymptomatic Infection ◽  
Skewed Distribution ◽  
Cross Sectional ◽  
Epidemiological Characteristics

BACKGROUND: Coronavirus disease (COVID)-19 has become a global pandemic with an increasing burden on healthcare. Early recognition of the trend and pattern of the chain of transmission is necessary to slow down the spread. AIM: Therefore, the study aimed to describe the epidemiology of COVID-19 at a local setting. METHODS: A retrospective cross-sectional study was done to all COVID-19 cases registered in Seremban Health District. Statistical analysis, using Chi-square test, was employed to compare the sociodemographic characteristic of COVID-19 patients between the red zone area and the non-red zone area in Seremban. RESULTS: As of April, a total of 214 number of COVID-19 cases reported in Seremban district alone. The trend of cases registered has changed as more asymptomatic infection outnumbered patients with clinical symptoms from the aggressive active case detection (ACD) activity. Majority of the cases affecting Malay ethnicity were due to a large religious gathering event held 1 month earlier than subsequently spread the infection within the community. CONCLUSION: The first wave of COVID-19 cases in Seremban was sudden and unexpected, with a skewed distribution affecting a particular race group regardless red zone area and non-red zone area. Therefore, identifying the pattern of infection in the local community is important for a focused intervention strategy. ACD strategy, isolation of patients, quarantine the exposed, tracking down the close contact, and continuous health promotion and education will ultimately break the chain of transmission.

scholarly journals Epidemiological and clinical characteristics of a familial cluster of COVID-19

2020 ◽  
Vol 148 ◽  
Author(s):  
Yong Sun ◽  
Lin Tian ◽  
Xiaomei Du ◽  
Hua Wang ◽  
Yueshan Li ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Family Member ◽  
Incubation Period ◽  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Epidemiological Investigation ◽  
Radiological Findings ◽  
Wuhan City ◽  
Familial Cluster ◽  
Family Cluster

Abstract We report a family cluster of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection involving five patients in a family cluster in Dazhou, China, including the epidemiological, clinical, laboratory and radiological findings. Three-generation transmission was observed. Through epidemiological investigation, we observed asymptomatic transmission to a cohabiting family member, as well as person-to-person transmission of SARS-CoV-2 outside Wuhan city. The asymptomatic transmission demonstrated here provides evidence that there could be a greater risk of Coronavirus Disease 2019 (COVID-19) spread. This cluster also demonstrated that COVID-19 is transmissible during the incubation period of an asymptomatic person. Early isolation and treatment, stressing prevention of cluster outbreaks, could help prevent further spread of the epidemic.

Nano Magnetic Beads Combined with Polymerase Chain Reaction Detection of 2019-nCoV and Analysis of the Epidemiological and Clinical Characteristics of 2019-nCoV Patients

2020 ◽  
Vol 12 (10) ◽  
pp. 1207-1214
Author(s):  
Lingyan Fan ◽  
Linsong Liu ◽  
Nanhong Zheng ◽  
Dezhou Li ◽  
Honghui Tu ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Clinical Characteristics ◽  
Magnetic Beads ◽  
Clinical Symptoms ◽  
Nasal Congestion ◽  
Nucleic Acid Detection ◽  
Research Subjects ◽  
Significant Difference ◽  
The Absolute ◽  
L 14

The 2019 novel coronavirus (2019-nCoV) is extremely infectious and the human population globally is generally susceptible to it. Its spread poses a serious threat to public health. Analyzing the epidemiological and clinical characteristics of patients with coronavirus disease 2019 (COVID-19) can more fully demonstrate its characteristics and evolution, and provide effective scientific strategies for preventing and controlling the epidemic. In this study, nucleic acid detection was performed on 228 suspected COVID-19 cases in Ningbo City from January 2020 to August 2020. The RNA of the virus was extracted by the nano magnetic bead method and was detected by real-time fluorescent quantitative PCR. Patients whose test results were positive were considered as research subjects. Clinical data of the patients were collected through a medical record system and the epidemiology and characteristics of COVID-19 were analyzed. Among the 228 suspected cases, 108 patients had a positive nucleic acid test result. The 108 confirmed patients were selected as research subjects, including 9 patients with mild symptoms, 85 patients with common symptoms, and 14 patients with severe symptoms. The age range of the patients was 17–82 years. Overall, 35 patients (32.40%) had complications. The median incubation period for patients was 7.5 days. Seventy patients (64.81%) had a contact history with a diseased individual. In terms of the clinical symptoms of the patients, the following symptoms were identified: fever in 92, cough in 62, fatigue in 34, sputum expectoration in 32, dry cough in 22, sore throat in 19, diarrhea in 8, headache in 8, shortness of breath in 7, nasal congestion in 5, and muscle ache in 5 cases. The results of chest CT imaging showed that 96 patients (88.89%) exhibited bilateral or unilateral pneumonia lesions of varying degrees, manifested as bilateral or unilateral lung patches, cloudy floccules, patches with an increased density shadow. The CT images of 12 patients (11.11%) showed no obvious abnormalities, while 24 cases (22.22%) had absolute white blood cell count of <4×109/L, while 1 case had one of >10×109/L. The absolute neutrophil count in 10 patients (9.26%) increased (>6.3×109/L). The absolute lymphocyte count in 49 patients (45.37%) decreased (<1.1×109/L). The hemoglobin, hematocrit, and platelet levels of the vast majority of patients were normal, while a few were low or high. Fifty-eight patients (53.70%) had elevated C-reactive protein (>10 mg/L); 14 (12.96%) had elevated D-dimer (>256 μg/L); 14 (12.96%) had high levels of alanine aminotransferase (>40 U/L); 9 (8.33%) had increased aspartate aminotransferase (>40 U/L); while 32 (29.6%) had increased lactate dehydrogenase (>250 U/L). COVID-19 in Ningbo is mainly transmitted in clusters, and elderly patients are more likely to develop severe symptoms. There is no significant difference in clinical characteristics between patients with severe conditions and those with mild and common ones.

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