4.6 Article

Comparison of Clinical Features and CT Temporal Changes Between Familial Clusters and Non-familial Patients With COVID-19 Pneumonia

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FRONTIERS IN MEDICINE
卷 8, 期 -, 页码 -

出版社

FRONTIERS MEDIA SA
DOI: 10.3389/fmed.2021.630802

关键词

coronavirus infections; pneumonia; tomography; X-ray computed; familial cluster

资金

  1. National Natural Science Foundation of China [81571664, 81871323]
  2. National Natural Science Foundation of Guangdong Province [2018B030311024]
  3. Scientific Research General Project of Guangzhou Science Technology and Innovation Commission [201707010328]
  4. China Postdoctoral Science Foundation [2016M600145]

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Patients in the familial cluster group with COVID-19 pneumonia had a worse clinical course and outcome compared to those in the non-familial group, requiring close monitoring and follow-ups.
Purpose: This study aimed to compare the clinical characteristics, laboratory findings, and chest computed tomography (CT) findings of familial cluster (FC) and non-familial (NF) patients with coronavirus disease 2019 (COVID-19) pneumonia. Methods: This retrospective study included 178 symptomatic adult patients with laboratory-confirmed COVID-19. The 178 patients were divided into FC (n = 108) and NF (n = 70) groups. Patients with at least two confirmed COVID-19 cases in their household were classified into the FC group. The clinical and laboratory features between the two groups were compared and so were the chest CT findings on-admission and end-hospitalization. Results: Compared with the NF group, the FC group had a longer period of exposure (13.1 vs. 8.9 days, p < 0.001), viral shedding (21.5 vs. 15.9 days, p < 0.001), and hospital stay (39.2 vs. 22.2 days, p < 0.001). The FC group showed a higher number of involved lung lobes on admission (3.0 vs. 2.3, p = 0.017) and at end-hospitalization (3.6 vs. 1.7, p < 0.001) as well as higher sum severity CT scores at end-hospitalization (4.6 vs. 2.7, p = 0.005) than did the NF group. Conversely, the FC group had a lower lymphocyte count level (p < 0.001) and a significantly lower difference in the number of involved lung lobes (Delta number) between admission and discharge (p < 0.001). Notably, more cases of severe or critical illness were observed in the FC group than in the NF group (p = 0.036). Conclusions: Patients in the FC group had a worse clinical course and outcome than those in the NF group; thus, close monitoring during treatment and follow-ups after discharge would be beneficial for patients with familial infections.

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