COVID-19 in a patient with long-term use of glucocorticoids: A study of a familial cluster

Clin Immunol. 2020 May;214:108413. doi: 10.1016/j.clim.2020.108413. Epub 2020 Apr 8.


Clusters of patients with novel coronavirus disease 2019 (COVID-19) have been successively reported globally. Studies show clear person-to-person transmission. The average incubation period is 2-14 days, and mostly 3-7 days. However, in some patients, this period may be longer. Here, we report a familial cluster of COVID-19 where a 47-year-old woman with long-term use of glucocorticoids did not develop any symptoms within the 14-day quarantine period but was confirmed with COVID-19 by tested positive of antibody on day 40 after she left Wuhan. Almost at the same time, her father and sister were diagnosed with COVID-19. The results suggest that the long-term use of glucocorticoids might cause atypical infections, a long incubation period, and extra transmission of COVID-19.

Keywords: Atypical infection; COVID-19; Familial cluster; Immunocompromised; Incubation period; Shedding duration.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged, 80 and over
  • Betacoronavirus
  • COVID-19
  • China
  • Coronavirus Infections / drug therapy*
  • Female
  • Glucocorticoids / administration & dosage*
  • Glucocorticoids / adverse effects*
  • Humans
  • Infectious Disease Incubation Period*
  • Lung / diagnostic imaging
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / drug therapy
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • SARS-CoV-2
  • Virus Shedding


  • Glucocorticoids