Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing study
Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing study
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DOI：
10.1016/j.jinf.2020.03.006
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发表时间：
2020-06-01
影响因子：
28.2
通讯作者：
Xu, Aman
中科院分区：
文献类型：
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作者：
Huang, Lei;Zhang, Xiuwen;Xu, Aman
背景：2019 年冠状病毒病（COVID-19）的爆发已迅速蔓延到武汉以外的许多地方。之前关于 COVID-19 的研究主要包括年龄较大的住院成人。关于感染 COVID-19 的青少年的传染性和特征的信息很少。方法：前瞻性追踪了中国安徽省 22 岁男性（患者指数）的 22 名密切接触者，其中包括实验室确诊的 COVID-19 青少年和重症急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 检测呈阴性的住院密切接触者。 2020 年 1 月 23 日，我们招募了 8 名患有 COVID-19 的青少年（中位年龄 [范围]，22 [16-23] 岁；六名男性），他们来自 Patient-Index，于 1 月 19 日从武汉返回合肥。Patient-Index 在返回后的晚上拜访了他 16 岁的表弟，并在 1 月 21 日的一次聚会中遇到了 15 名以前的同学。 1 月 19 日至 21 日期间，他无症状，所有接触者均描述其健康。他的第一个症状是眼睛发痒，并分别于1月22日中午和下午出现发烧。七名年轻人（他的表弟和六名同学）在与 Patient-Index 接触几个小时后感染了 COVID-19。所有患者和接触者均未在三个月内去过武汉（患者指数除外），或接触过菜市场、野生动物或医疗机构。对于受影响的青少年，潜伏期中位数为 2 天（范围为 1-4 天）。中位序列间隔为 1 天（范围，0-4）。八名感染 COVID-19 的青少年中有一半或以上在入院时出现发烧、咳嗽、咳痰、鼻塞和疲劳等症状。所有患者病情均较轻。六名患者入院时出现肺炎（均为轻度；一名双侧）。截至2月20日，已有4名患者出院。结论：SARS-CoV-2感染在潜伏期表现出较强的传染性，在武汉以外的青少年聚集性人群中传播速度快。这些年轻人中出现的 COVID-19 起病快，有各种非特异性非典型表现，而且比之前报道的老年患者轻得多。 (C) 2020 英国感染协会。由爱思唯尔有限公司出版。保留所有权利。
Background: The outbreak of coronavirus-disease-2019 (COVID-19) has rapidly spread to many places outside Wuhan. Previous studies on COVID-19 mostly included older hospitalized-adults. Little information on infectivity among and characteristics of youngsters with COVID-19 is available.Methods: A cluster of 22 close-contacts of a 22-year-old male (Patient-Index) including youngsters with laboratory-confirmed COVID-19 and hospitalized close-contacts testing negative for severe-acuterespiratory-syndrome-coronavirus-2 (SARS-CoV-2) in Anhui Province, China was prospectively-traced.Results: Since January 23, 2020, we enrolled a cluster of eight youngsters with COVID-19 (median age [range], 22 [16-23] years; six males) originating from Patient-Index returning from Wuhan to Hefei on January 19. Patient-Index visited his 16-year-old female cousin in the evening on his return, and met 15 previous classmates in a get-together on January 21. He reported being totally asymptomatic and were described by all his contacts as healthy on January 19-21. His very first symptoms were itchy eyes and fever developed at noon and in the afternoon on January 22, respectively. Seven youngsters (his cousin and six classmates) became infected with COVID-19 after a-few-hour-contact with Patient-Index. None of the patients and contacts had visited Wuhan (except Patient-Index), or had any exposure to wet-markets, wild-animals, or medical-institutes within three months. For affected youngsters, the median incubation-period was 2 days (range, 1-4). The median serial-interval was 1 day (range, 0-4). Half or more of the eight COVID-19-infected youngsters had fever, cough, sputum production, nasal congestion, and fatigue on admission. All patients had mild conditions. Six patients developed pneumonia (all mild; one bilateral) on admission. As of February 20, four patients were discharged.Conclusions: SARS-CoV-2-infection presented strong infectivity during the incubation-period with rapid transmission in this cluster of youngsters outside Wuhan. COVID-19 developed in these youngsters had fast onset and various nonspecific atypical manifestations, and were much milder than in older patients as previously reported. (C) 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.