Clinical characteristics of COVID-19 in family clusters: a systematic review

Background Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has spread around the world and reports of children during early epidemic period showed features of family clusters.The aim of this study is to assess clinical profiles of COVID-19 in family clusters with children.Methods We performed a systematic literature review of English database(PubMed,Web of Science)and Chinese database(“www.cnki.net”,“www.cqvip.com”and“www.Wanfangdata.com.cn”)to identify papers on family clusters of COVID-19 with children and their family members.Results Eighteen studies involving 34 children and 98 adults from 28 families were included.Fever,cough and ground-grass opacity change of chest computed tomography(CT)were the dominant features,whereas proportion of asymptomatic infections for children was higher than adults with statistical significance(32.4%and 13.3%,respectively,P<0.05).Median time of longer incubation period(10 days)and shorter duration of pharyngeal swab nucleic acid test positive period(11 days)were seen in children than adults(7 and 17 days,respectively)with statistical significance(P<0.05).There were statistically significant differences in lymphopenia,increased C-reactive protein and abnormal chest CT between children and adult patients(P<0.05).Twenty-seven families reported adults as first case of COVID-19 in family clusters.Conclusions The same virus strain can cause milder disease in children compared with their caregivers.Children of COVID-19 were infected by adults in family during the early epidemic period.Asymptomatic patients can transmit the virus.

Virology features of a family cluster of SARS-CoV-2 infections in Shanghai,China

The global spread of SARS-CoV-2 is currently continuing,and the World Health Organization has announced the risk assessment of the viruses as high.In this study,we analyzed virology features of SARS-CoV-2 causing a family cluster outbreak.Among the six family members,five have been laboratory-confirmed infection of SARS-CoV-2 viruses.A total of five SARS-CoV-2 viruses have been isolated from the nasopharyngeal swabs.The complete genome of the viruses exhibited 100%nucleotide identity with each other.Only two nucleotide differences have been observed between genomes of the isolated viruses and the HCoV/Wuhan/IVDC-HB-01/2019 strain.Therefore,SARS-CoV-2 has been confirmed as the causation of the family cluster infections.

Family-based Helicobacter pylori infection status and transmission pattern in central China,and its clinical implications for related disease prevention

BACKGROUND Helicobacter pylori(H.pylori)has characteristics of family cluster infection;however,its family-based infection status,related factors,and transmission pattern in central China,a high-risk area for H.pylori infection and gastric cancer,have not been evaluated.We investigated family-based H.pylori infection in healthy households to understand its infection status,related factors,and patterns of transmission for related disease prevention.AIM To investigate family-based H.pylori infection status,related factors,and patterns of transmission in healthy households for related disease prevention.METHODS Blood samples and survey questionnaires were collected from 282 families including 772 individuals.The recruited families were from 10 selected communities in the greater Zhengzhou area with different living standards,and the family members’general data,H.pylori infection status,related factors,and transmission pattern were analyzed.H.pylori infection was confirmed primarily by serum H.pylori antibody arrays;if patients previously underwent H.pylori eradication therapy,an additional 13C-urea breath test was performed to obtain their current infection status.Serum gastrin and pepsinogens(PGs)were also analyzed.RESULTS Among the 772 individuals examined,H.pylori infection rate was 54.27%.These infected individuals were from 246 families,accounting for 87.23%of all 282 families examined,and 34.55%of these families were infected by the same strains.In 27.24%of infected families,all members were infected,and 68.66%of them were infected with type I strains.Among the 244 families that included both husband and wife,spouse co-infection rate was 34.84%,and in only 17.21%of these spouses,none were infected.The infection rate increased with duration of marriage,but annual household income,history of smoking,history of alcohol consumption,dining location,presence of gastrointestinal symptoms,and family history of gastric disease or GC did not affect infection rates;however,individuals who had a higher education level showed lower infection rates.The levels of gastrin-17,PGI,and PGII were significantly higher,and PGI/II ratio was significantly lower in H.pylori-infected groups than in H.pylori-negative groups.CONCLUSION In our study sample from the general public of central China,H.pylori infection rate was 54.27%,but in 87.23%of healthy households,there was at least 1 H.pylori-infected person;in 27.24%of these infected families,all members were infected.Type I H.pylori was the dominant strain in this area.Individuals with a higher education level showed significantly lower infection rates;no other variables affected infection rates.

Epidemiological and clinical characteristics of 35 children with COVID-19 in Beijing,China

Importance:Within the coronavirus disease 2019(COVID-19)global pandemic,more attention is warranted for whether this new infectious disease has unique manifestations in children.Objective:To retrospectively determine the epidemiological and clinical characteristics of 35 children with COVID-19 in Beijing,China.Methods:We collected data for 35 children diagnosed with COVID-19 who were admitted to Beijing Ditan Hospital from January 2020 to June 2020,and analyzed their epidemiological characteristics,clinical manifestations,laboratory examinations,chest imaging findings,treatments,and outcomes.Results:The children comprised 18 boys(51.4%)and 17 girls(48.6%)aged 6 months to 15 years.All patients had clear epidemiological history,with family clusters accounting for 28 cases(80.0%)and clear tracing of exposure to high epidemic areas in the remaining 7 cases(20.0%).Four(11.4%)patients were classified as asymptomatic,17(48.6%)as acute upper respiratory infection,and 14(40.0%)as mild pneumonia,with no severe or critical cases.Clinical manifestations were mild,including fever in 18(51.4%),cough in 14(40.0%),and nausea and diarrhea in 7(20.0%)patients.White blood cell count was mostly normal(26 cases,74.3%)or decreased(7 cases,20.0%);lymphocyte percentage was increased in 24(68.7%);neutrophil percentage was decreased in 25(71.4%);alanine aminotransferase was increased in 3(8.6%);and serum potassium was decreased in 4(11.4%).Time to negative viral nucleic acid testing was 2-42 days(mean:14.0±9.4 days).Chest imaging examination revealed that 20 patients(57.1%)had different forms of lung inflammation.Treatment was mainly isolation and nutritional support.Eleven patients were treated with interferon atomization inhalation.No patients required oxygen therapy.All 35 children were cured and discharged.Length of hospital stay was 9-54 days(mean:25.4±13.8 days).During regular follow-up after discharge,5 children showed positivity again in the viral nucleic acid test and were re-hospitalized for observation and treatment.The mean length of re-hospitalization stay was 10.8 days.Interpretation:Children with COVID-19 mainly become infected within their family,and children of all ages are generally susceptible.The disease in children is mostly mild and the prognosis is good.Nucleic acid tests in some patients become positive again after discharge,suggesting that it is of great significance to carry out centralized isolation medical observations and active nucleic acid tests in close contacts for early detection of patients and routine epidemic prevention and control.