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. 2020 May;94:133-138.
doi: 10.1016/j.ijid.2020.03.042. Epub 2020 Apr 2.

Delivery of infection from asymptomatic carriers of COVID-19 in a familial cluster

Feng Ye  1 , Shicai Xu  2 , Zhihua Rong  3 , Ronghua Xu  4 , Xiaowei Liu  5 , Pingfu Deng  6 , Hai Liu  7 , Xuejun Xu  8
Affiliations
Free PMC article

Delivery of infection from asymptomatic carriers of COVID-19 in a familial cluster

Feng Ye et al. Int J Infect Dis. 2020 May.
Free PMC article

Abstract

Objectives: With the ongoing outbreak of COVID-19 around the world, it has become a worldwide health concern. One previous study reported a family cluster with an asymptomatic transmission of COVID-19. Here, we report another series of cases and further demonstrate the repeatability of the transmission of COVID-19 by pre-symptomatic carriers.

Methods: A familial cluster of five patients associated with COVID-19 was enrolled in the hospital. We collected epidemiological and clinical characteristics, laboratory outcomes from electronic medical records, and also verified them with the patients and their families.

Results: Among them, three family members (Case 3/4/5) had returned from Wuhan. Additionally, two family members, those who had not traveled to Wuhan, also contracted COVID-19 after contacting with the other three family members. Case 1 developed severe pneumonia and was admitted to the ICU. Case 3 and Case 5 presented fever and cough on days two through three of hospitalization and had ground-glass opacity changes in their lungs. Case 4 presented with diarrhea and pharyngalgia after admission without radiographic abnormalities. Case 2 presented no clinical nor radiographic abnormalities. All five cases had an increasing level of C-reactive protein.

Conclusions: Our findings indicate that COVID-19 can be transmitted by asymptomatic carriers during the incubation period.

Keywords: Asymptomatic carrier; COVID-19; Incubation period; Pneumonia; SARS-CoV-2.

Figures

Fig. 3
Fig. 3
The relationship between the 5 cases and their general information.
Fig. 1
Fig. 1
Respectively, the chest CT images of five Cases. (A) Massive shadows of high density of Case 1. (B/D) No abnormalities of Case 2 and Case 4. (C/E) Ground-glass changes of Case 3 and Case 5.
Fig. 2
Fig. 2
Timeline of exposure to the asymptomatic carrier of COVID-19 which leads to a familial cluster infection.
See this image and copyright information in PMC

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