Corpus overview


MeSH Disease

Human Phenotype

Fever (22)

Cough (17)

Pneumonia (14)

Fatigue (7)

Diarrhea (6)


    displaying 1 - 10 records in total 94
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    Use of a humanized anti-CD6 monoclonal antibody SERO (itolizumab) in elderly TRANS patients with moderate COVID-19

    Authors: Mayra Ramos-Suzarte; Yayquier Diaz; Yordanis Martin; Nestor Antonio Calderon; William Santiago; Orlando Vinet; Yulieski La O; Jorge Perez; Augusto Oyarzabal; Yoan Perez; Geidy Lorenzo; Meylan Cepeda; Danay Saavedra; Zayma Mazorra; Daymys Estevez; Patricia Lorenzo-Luaces; Carmen Valenzuela; Armando Caballero; Kalet leon; Tania Crombet; Carlos Jorge Hidalgo

    doi:10.1101/2020.07.24.20153833 Date: 2020-07-30 Source: medRxiv

    Abstract Introduction: The Severe Acute Respiratory Syndrome MESHD Coronavirus 2 (SARS-CoV-2) has caused a recent outbreak of Coronavirus Disease MESHD (COVID-19). In Cuba, the first case of COVID-19 was reported on March 11. Elderly TRANS with multiple comorbidities are particularly susceptible to adverse clinical outcomes in the course of SARS CoV-2 infection MESHD. During the outbreak, a local transmission TRANS event took place in a nursing home in Villa Clara province, Cuba, in which nineteen elderly TRANS residents were positive for SARS-CoV-2. Methods: Based on the increased susceptibility to viral-induced cytokine release syndrome MESHD inducing respiratory and systemic complications in this population, the patients were included in an expanded access clinical trial to receive itolizumab, an anti-CD6 monoclonal antibody SERO. Results: All the patients had underlying medical conditions. The product was well tolerated. After the first dose, the course of the disease MESHD was favorable and 18 out of 19 (94.7%) patients were discharged clinically recovered with negative RT-PCR at 13 days (median). One dose of itolizumab, circulating IL-6 decreased in the first 24-48 hours in patients with high baseline values, whereas in patients with low levels, this concentration remained over low values. To preliminary assess the effect of itolizumab, a control group was selected among the Cuban COVID-19 patients, which did not receive immunomodulatory therapy. Control subjects were well-matched regarding age TRANS, comorbidities and severity of the disease MESHD. Every three moderately ill patients treated with itolizumab, one admission in intensive care unit (ICU) was prevented. Discussion/Conclusion: Itolizumab was well tolerated. Its effect is associated with a reduction and controlling IL-6 serum SERO levels. Moreover, treated patients had a favorable clinical outcome, considering their poor prognosis. This treatment is associated significantly with a decrease the risk to be admitted in ICU and reduced 10 times the risk of death MESHD. This study corroborates that the timely use of itolizumab, in combination with other antiviral and anticoagulant therapies, is associated with a reduction the COVID-19 disease MESHD worsening and mortality. The humanized antibody SERO itolizumab emerges as a therapeutic alternative for patients with COVID-19 and suggests its possible use in patients with cytokine release syndrome MESHD from other pathologies.

    Serial population based serosurvey of antibodies to SARS-CoV-2 SERO in a low and high transmission TRANS area of Karachi, Pakistan

    Authors: Muhammad Imran Nisar; Nadia Ansari; Mashal Amin; Farah Khalid; Aneeta Hotwani; Najeeb Rehman; Arjumand Rizvi; Arslan Memon; Zahoor Ahmed; Ashfaque Ahmed; Junaid Iqbal; Ali Faisal Saleem; Uzma Bashir Aamir; Daniel B Larremore; Bailey Fosdick; Fyezah Jehan

    doi:10.1101/2020.07.28.20163451 Date: 2020-07-29 Source: medRxiv

    Background Pakistan is among the first low- and middle-income countries affected by COVID-19 pandemic. Monitoring progress through serial sero-surveys SERO, particularly at household level, in densely populated urban communities can provide insights in areas where testing is non-uniform. Methods Two serial cross-sectional household surveys were performed in April (phase 1) and June (phase 2) 2020 each in a low- (District Malir) and high- transmission TRANS (District East) area of Karachi, Pakistan. Household were selected using simple random sampling (Malir) and systematic random sampling (East). Individual participation rate from consented households was 82.3% (1000/1215 eligible) in phase 1 and 76.5% (1004/1312 eligible) in phase 2. All household members or their legal guardians answered questions related to symptoms of Covid-19 and provided blood SERO for testing with commercial Elecsys Anti-SARS-CoV-2 immunoassay SERO targeting combined IgG and IgM. Seroprevalence SERO estimates were computed for each area and time point independently. Given correlation among household seropositivity values, a Bayesian regression model accounting for household membership, age TRANS and gender TRANS was used to estimate seroprevalence SERO. These estimates by age TRANS and gender TRANS were then post-stratified to adjust for the demographic makeup of the respective district. The household conditional risk of infection TRANS risk of infection TRANS infection MESHD was estimated for each district and its confidence interval were obtained using a non-parametric bootstrap of households. Findings Post-stratified seroprevalence SERO was estimated to be 0.2% (95% CI 0-0.7) in low-and 0.4% (95% CI 0 - 1.3) in high- transmission TRANS areas in phase 1 and 8.7% (95% CI 5.1-13.1) in low- and 15.1% (95% CI 9.4 -21.7) in high- transmission TRANS areas in phase 2, with no consistent patterns between prevalence SERO rates for males TRANS and females TRANS. Conditional risk of infection TRANS risk of infection TRANS infection MESHD estimates (possible only for phase 2) were 0.31 (95% CI 0.16-0.47) in low- and 0.41(95% CI 0.28-0.52) in high- transmission TRANS areas. Of the 166 participants who tested positive, only 9(5.4%) gave a history of any symptoms. Interpretation A large increase in seroprevalence SERO to SARS-CoV-2 infection MESHD is seen, even in areas where transmission TRANS is reported to be low. Mostly the population is still seronegative. A large majority of seropositives do not report any symptoms. The probability that an individual in a household is infected, given that another household member is infected is high in both the areas. These results emphasise the need to enhance surveillance activities of COVID-19 especially in low- transmission TRANS sites and provide insights to risks of household transmission TRANS in tightly knit neighbourhoods in urban LMIC settings.

    Longitudinal COVID-19 Surveillance and Characterization in the Workplace with Public Health and Diagnostic Endpoints

    Authors: Manjula Gunawardana; Jessica Breslin; John M Cortez; Sofia Rivera; Simon Webster; F Javier Ibarrondo; Otto O Yang; Richard B Pyles; Christina M Ramirez; Amy P Adler; Peter A Anton; Marc M Baum

    doi:10.1101/2020.07.25.20160812 Date: 2020-07-28 Source: medRxiv

    Background The rapid spread of severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) and the associated coronavirus disease MESHD 2019 (COVID-19) have precipitated a global pandemic heavily challenging our social behavior, economy, and healthcare infrastructure. Public health practices currently represent the primary interventions for managing the spread of the pandemic. We hypothesized that frequent, longitudinal workplace disease MESHD surveillance would represent an effective approach to controlling SARS-CoV-2 transmission TRANS among employees and their household members, reducing potential economic consequences and loss of productivity of standard isolation methods, while providing new insights into viral-host dynamics. Methodology and Findings On March 23, 2020 a clinical study (OCIS-05) was initiated at a small Southern California organization. Results from the first 3 months of the ongoing study are presented here. Study participants (27 employees and 27 household members) consented to provide frequent nasal or oral swab samples that were analyzed by RT-qPCR for SARS-CoV-2 RNA using CDC protocols. Only participants testing negative were allowed to enter the "safe zone" workplace facility. Optional blood SERO samples were collected at baseline and throughout the 3-month study. Serum SERO virus-specific antibody SERO concentrations (IgG, IgM, and IgA) were measured using a selective, sensitive, and quantitative ELISA assay SERO developed in house. A COVID-19 infection MESHD model, based on traditional SEIR compartmental models combined with Bayesian non-linear mixed models and modern machine learning, was used to predict the number of employees and household members who would have become infected in the absence of workplace surveillance. Two study participants were found to be infected by SARS-CoV-2 during the study. One subject, a household member, tested positive clinically by RT-qPCR prior to enrollment and experienced typical COVID-19 symptoms that did not require hospitalization. While on study, the participant was SARS-CoV-2 RNA positive for at least 71 days and had elevated virus-specific antibody SERO concentrations (medians: IgM, 9.83 ug mL-1; IgG, 11.5 ug mL-1; IgA, 1.29 ug mL-1) in serum samples SERO collected at three timepoints. A single, unrelated employee became positive for SARS-CoV-2 RNA over the course of the study, but remained asymptomatic TRANS with low associated viral RNA copy numbers. The participant did not have detectable serum SERO IgM and IgG concentrations, and IgA concentrations decayed rapidly (half-life: 1.3 d). The employee was not allowed entry to the safe zone workplace until testing negative three consecutive times over 7 d. No other employees or household members contracted COVID-19 over the course of the study. Our model predicted that under the current prevalence SERO in Los Angeles County without surveillance intervention, up to 7 employees (95% CI = 3-10) would have become infected with at most 1 of them requiring hospitalizations and 0 deaths MESHD. Conclusions Our clinical study met its primary objectives by using intense longitudinal testing to provide a safe work environment during the COVID-19 pandemic, and elucidating SARS-CoV-2 dynamics in recovering and asymptomatic TRANS participants. The surveillance plan outlined here is scalable and transferrable. The study represents a powerful example on how an innovative public health initiative can be dovetailed with scientific discovery.

    SARS-CoV-2 viral load dynamics, duration of viral shedding and infectiousness: a living systematic review and meta-analysis

    Authors: Muge Cevik; Matthew Tate; Oliver Lloyd; Alberto Enrico Maraolo; Jenna Schafers; Antonia Ho

    doi:10.1101/2020.07.25.20162107 Date: 2020-07-28 Source: medRxiv

    Background Viral load kinetics and the duration of viral shedding are important determinants for disease MESHD transmission TRANS. We aim i) to characterise viral load dynamics, duration of viral RNA, and viable virus shedding of SARS-CoV-2 in various body fluids and ii) to compare SARS-CoV-2 viral dynamics with SARS-CoV-1 and MERS-CoV. Methods: Medline, EMBASE, Europe PMC, preprint servers and grey literature were searched to retrieve all articles reporting viral dynamics and duration of SARS-CoV-2, SARS-CoV-1 and MERS-CoV shedding. We excluded case reports and case series with < 5 patients, or studies that did not report shedding duration from symptom onset TRANS. PROSPERO registration: CRD42020181914. Findings: Seventy-nine studies on SARS-CoV-2, 8 on SARS-CoV-1, and 11 on MERS-CoV were included. Mean SARS-CoV-2 RNA shedding duration in upper respiratory tract, lower respiratory tract, stool and serum SERO were 17.0, 14.6, 17.2 and 16.6 days, respectively. Maximum duration of SARS-CoV-2 RNA shedding reported in URT, LRT, stool and serum SERO was 83, 59, 35 and 60 days, respectively. Pooled mean duration of SARS-CoV-2 RNA shedding was positively associated with age TRANS (p=0.002), but not gender TRANS (p = 0.277). No study to date has detected live virus beyond day nine of illness despite persistently high viral loads. SARS-CoV-2 viral load in the upper respiratory tract appears to peak in the first week of illness, while SARS-CoV-1 and MERS-CoV peak later. Conclusion: Although SARS-CoV-2 RNA shedding in respiratory and stool can be prolonged, duration of viable virus is relatively short-lived. Thus, detection of viral RNA cannot be used to infer infectiousness. High SARS-CoV-2 titres are detectable in the first week of illness with an early peak observed at symptom onset TRANS to day 5 of illness. This review underscores the importance of early case finding and isolation, as well as public education on the spectrum of illness. However, given potential delays in the isolation of patients, effective containment of SARS-CoV-2 may be challenging even with an early detection and isolation strategy. Funding: No funding was received.

    Viral RNA level, serum SERO antibody SERO responses, and transmission risk TRANS in discharged COVID-19 patients with recurrent positive SARS-CoV-2 RNA test results: a population-based observational cohort study

    Authors: Chao Yang; Min Jiang; Xiaohui Wang; Xiujuan Tang; Shisong Fang; Hao Li; Le Zuo; Yixiang Jiang; Yifan Zhong; Qiongcheng Chen; Chenli Zheng; Lei Wang; Shuang Wu; Weihua Wu; Hui Liu; Jing Yuan; Xuejiao Liao; Zhen Zhang; Yiman Lin; Yijie Geng; Huan Zhang; Huanying Zheng; Min Wan; Linying Lu; Xiaohu Ren; Yujun Cui; Xuan Zou; Tiejian Feng; Junjie Xia; Ruifu Yang; Yingxia Liu; Shujiang Mei; Baisheng Li; Zhengrong Yang; Qinghua Hu

    doi:10.1101/2020.07.21.20125138 Date: 2020-07-26 Source: medRxiv

    Background Managing discharged COVID-19 (DC) patients with recurrent positive (RP) SARS-CoV-2 RNA test results is challenging. We aimed to comprehensively characterize the viral RNA level and serum SERO antibody SERO responses in RP-DC patients and evaluate their viral transmission risk TRANS. Methods A population-based observational cohort study was performed on 479 DC patients discharged from February 1 to May 5, 2020 in Shenzhen, China. We conducted RT-qPCR, antibody SERO assays, neutralisation assays, virus isolation, whole genome sequencing (WGS), and epidemiological investigation of close contacts TRANS. Findings Of 479 DC patients, the 93 (19%) RP individuals, including 36 with multiple RP results, were characterised by young age TRANS (median age TRANS: 34 years, 95% confidence interval [CI]: 29-38 years). The median discharge-to-RP length was 8 days (95% CI: 7-14 days; maximum: 90 days). After readmission, RP-DC patients exhibited mild (28%) or absent (72%) symptoms, with no disease progression MESHD. The viral RNA level in RP-DC patients ranged from 1.9-5.7 log10 copies/mL (median: 3.2, 95% CI: 3.1-3.5). At RP detection, the IgM, IgG, IgA, total antibody, and neutralising SERO antibody SERO (NAb) seropositivity rates in RP-DC patients were 38% (18/48), 98% (47/48), 63% (30/48), 100% (48/48), and 91% (39/43), respectively. Regarding antibody SERO levels, there was no significant difference between RP-DC and non-RP-DC patients. The antibody SERO level remained constant in RP-DC patients pre- and post-RP detection. Virus isolation of nine representative specimens returned negative results. WGS of six specimens yielded only genomic fragments. No clinical symptoms were exhibited by 96 close contacts TRANS of 23 RP-DC patients; their viral RNA (96/96) and antibody SERO (20/20) test results were negative. After full recovery, 60% of patients (n=162, 78 no longer RP RP-DC and 84 non-RP-DC) had NAb titres of [≥]1:32. Interpretation RP may occur in DC patients following intermittent and non-stable excretion of low viral RNA levels. RP-DC patients pose a low risk of transmitting SARS-CoV-2. An NAb titre of [≥]1:32 may provide a reference indicator for evaluating humoral responses in COVID-19 vaccine clinical trials.

    SARS-CoV-2 antibody SERO prevalence SERO in health care workers: Preliminary report of a single center study

    Authors: Michael Brant-Zawadzki; Deborah Fridman; Philip Robinson; Matthew Zahn; Randy German; Marcus Breit; Junko Hara

    doi:10.1101/2020.07.20.20158329 Date: 2020-07-25 Source: medRxiv

    SARS-CoV-2 has driven a pandemic crisis. Serological surveys have been conducted to establish prevalence SERO for covid-19 antibody SERO in various cohorts and communities. However, the prevalence SERO among healthcare workers is still being analyzed. The present study reports on initial sero-surveillance conducted on healthcare workers at a regional hospital system in Orange County, California, during May and June, 2020. Study participants were recruited from the entire hospital employee workforce and the independent medical staff. Data were collected for job title, location, covid-19 symptoms, a PCR test history, travel TRANS record since January 2020, and existence of household contacts TRANS with covid-19. A blood SERO sample was collected from each subject for serum SERO analysis for IgG antibodies SERO to SARS-CoV-2. Of 3,013 tested individuals, a total 2,932 were included in the analysis due to some missing data. Observed prevalence SERO of 1.06% (31 antibody SERO positive cases), adjusted prevalence SERO of 1.13% for test sensitivity SERO and specificity were identified. Significant group differences between positive vs. negative were observed for age TRANS (z = 2.65, p = .008), race (p = .037), presence of fever MESHD fever HP (p < .001) and loss of smell (p < .001). Possible explanation for this low prevalence SERO includes a relatively low local geographic community prevalence SERO (~4.4%) at the time of testing, the hospital's timely procurement of personal protective equipment, rigorous employee education, patient triage and treatment protocol development and implementation. In addition, possible greater presence of cross-reactive adaptive T cell mediated immunity in healthcare workers vs. the general population may have contributed. Determining antibody SERO prevalence SERO in front-line workers, and duration of antibody SERO presence may help stratify the workforce for risk, establish better health place policies and procedures, and potentially better mitigate transmission TRANS.

    In-Utero Mother-to- Child TRANS SARS-CoV-2 Transmission TRANS: Viral Detection and Fetal Immune Response

    Authors: Claudio Fenizia; Mara Biasin; Irene Cetin; Patrizia Vergani; Davide Mileto; Arsenio Spinillo; Maria Rita Gismondo; Francesca Perrotti; Clelia Callegari; Alessandro Mancon; Selene Cammarata; Ilaria Beretta; Manuela Nebuloni; Daria Trabattoni; Mario Clerici; Valeria Savasi

    doi:10.21203/ Date: 2020-07-19 Source: ResearchSquare

    Pregnancy is known to increase the risk of severe illnesses in response to viral infections MESHD. Therefore, the impact of SARS-CoV-2 infection MESHD during gestational ages TRANS might be detrimental and the potential vertical transmission TRANS should be thoroughly studied.Herein, we investigated whether SARS-CoV-2 vertical transmission TRANS is possible and, in case, whether this results in a fetal involvement. Additionally, we analyzed the role of the antibody SERO and the inflammatory responses in placenta and plasma SERO from SARS-CoV-2-positive pregnant women and fetuses.31 SARS-CoV-2 pregnant women were enrolled. Real-time PCR was performed to detect the virus on maternal and newborns’ nasopharyngeal swabs, vaginal swabs, maternal and umbilical cord plasma SERO, placenta and umbilical cord biopsies, amniotic fluids and milk. Maternal and umbilical cord plasma SERO, and milk were tested for specific anti- SARS-CoV-2 antibodies SERO. RNA expression quantification of genes involved in the inflammatory response was performed on four selected placentas. On maternal and umbilical cord plasma SERO of the same subjects, secreted cytokines/chemokines were quantified.SARS-CoV-2 is found in at-term placentae and in the umbilical cord blood SERO, in the vaginal mucosa of pregnant women and in milk. Furthermore, we report the presence of specific anti-SARS-CoV-2 IgM and IgG antibodies SERO in the umbilical cord blood SERO of pregnant women, as well as in milk specimens. Finally, a specific inflammatory response is triggered by SARS-CoV-2 infection MESHD in pregnant women at both systemic and placental level, and in umbilical cord blood SERO plasma SERO.Our data strongly support the hypothesis that in-utero vertical transmission TRANS is possible in SARS-CoV-2 positive pregnant women. This is essential for defining proper obstetric management of COVID-19 pregnant women, or putative indications for mode and timing of delivery.

    Anti-SARS-CoV-2 IgG antibodies SERO in adolescent students and their teachers in Saxony, Germany (SchoolCoviDD19): very low seropraevalence and transmission TRANS rates

    Authors: Jakob Peter Armann; Manja Unrath; Carolin Kirsten; Christian Lueck; Alexander Dalpke; Reinhard Berner

    doi:10.1101/2020.07.16.20155143 Date: 2020-07-17 Source: medRxiv

    Background: School closures are part of the SARS-CoV-2 pandemic control measures in many countries, based on the assumption that children TRANS play a similar role in transmitting SARS-CoV-2 as they do in transmitting influenza. We therefore performed a SARS-CoV-2 seropraevalence-study in students and teachers to assess their role in the SARS-CoV-2 transmission TRANS. Methods: Students grade 8-11 and their teachers in 13 secondary schools in eastern Saxony, Germany, were invited to participate in the SchoolCoviDD19 study. Blood SERO samples were collected between May 25th and June 30th, 2020. Anti-SARS-CoV-2 IgG were assed using chemiluminescence immunoassay SERO technology and all samples with a positive or equivocal test result were re-tested with two additional serological tests SERO. Findings: 1538 students and 507 teachers participated in this study. The seropraevalence for SARS-CoV-2 was 0.6%. Even in schools with reported Covid-19 cases before the Lockdown of March 13th no clusters could be identified. 23/24 participants with a household history of COVID-91 were seronegative. By using a combination of three different immunoassays SERO we could exclude 16 participants with a positive or equivocal results after initial testing. Interpretation: Students and teachers do not play a crucial role in driving the SARS-CoV-2 pandemic in a low prevalence SERO setting. Transmission TRANS in families occurs very infrequently, and the number of unreported cases is low in this age group TRANS, making school closures not appear appropriate as a strategy in this low prevalence SERO settings. Funding: This study was supported by a grant from the state of Saxony

    Joint CBC-ICT Interpretation for the pre-surgical screening of COVID 19 asymptomatic TRANS cases: A cross-sectional study

    Authors: Tanzeel Imran; Humera Altaf Naz; Hamza Khan; Ali Haider Bangash; Laraib Bakhtiar Khan; Haroon Khan

    doi:10.1101/2020.07.16.20138354 Date: 2020-07-17 Source: medRxiv

    Background On 26th, February 2020, first cases of COVID 19 were confirmed in Pakistan. Since then, surgeries were halted in a bid to prevent transmission TRANS. However, since such a long halt is infeasible, a general protocol of screening the carriers TRANS, especially asymptomatic TRANS carries, is a dire need of time. The objective of our study is to propose an economically feasible protocol of COVID 19 screening. Simple but effective screening strategies can help to restore the workings of hospital surgical departments. Methods We analyzed the clinical data of patients turning up for elective surgeries at the Rawal General Hospital (RGH), Islamabad from the 24th of March to the 15th of May, 2020. Asymptomatic TRANS patients with negative COVID 19 contact and travel TRANS histories were screened with COVID 19 Immunochromatography (ICT) IgM / IgG Ab Test. Complete blood SERO count (CBC) was done and interpreted in conjunction with the ICT results. Results 39 patients with a mean age TRANS of 49 years were studied. The result of ICT for COVID-19 was positive in 9 cases (23%). The entire positive ICT patients population expressed significantly lower lymphocyte count (p<0.01); 8 patients had high monocyte count (p<0.05) whereas only 4 patients had a combined high neutrophil and monocyte count (P<0.05). All of these four patients with high neutrophil count were females TRANS. The combined interpretation of CBC and ICT IgM / IgG Ab Test had a high accuracy in diagnosing asymptomatic TRANS COVID-19 carriers TRANS that were later confirmed by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). Conclusion We propose that joint CBC-ICT interpretation should be adopted on a large scale to help in the diagnoses of asymptomatic TRANS carriers TRANS as both tests are simple and inexpensive and thus suit the developing countries limited health budget. Future research projects should be adopted in order to assess the accuracy of the proposed protocol on a large scale. Keywords: COVID-19, Surgery, Asymptomatic TRANS carriers TRANS, ICT, CBC.

    Presymptomatic Transmission TRANS and Diverse Progression of Familial Clustering Covid-19 Cases in Zhoushan, China

    Authors: Miao Liu; Leijie Liu; Ping Li; Yibo Ding; Ting Wu; Weina Tang; Zhongfa Wang; Guangwen Cao

    doi:10.21203/ Date: 2020-07-16 Source: ResearchSquare

    Background Novel coronavirus disease MESHD 2019 (COVID-19), severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2)-caused emerging infectious disease MESHD, firstly identified in Wuhan (Hubei, China), is pandemic. However, data concerning presymptomatic SARS-CoV-2 transmission TRANS and disease MESHD diversity among family members TRANS are limited. Herein, We investigated the epidemiological and clinical characteristics of presymptomatic transmission TRANS-caused familial clustering cases of SARS-CoV-2 infection MESHD in Zhoushan island, China.Methods All family members TRANS were tested for SARS-CoV-2 genomic RNA by quantitative reverse transcription PCR in 3 different samples and serum SERO antibody SERO immunoglobin M (IgM) and IgG against SARS-CoV-2. Exposure identification, laboratory test, and imaging were performed according to the national guideline of COVID-19 (7th edition, China).Results Of the 6 cases, index case who ever met his relative with COVID-19 from Xianning, Hubei on January 26–31, 2020, transmitted SARS-CoV-2 to his family members TRANS in Zhoushan via visiting family during January 31 and February 3, 2020. The index was identified as common-type COVID-19 on February 6, 2020. All 5 family members TRANS were infected with SARS-CoV-2. Of those, a 7-year-old girl was an asymptomatic TRANS carrier TRANS whereas her grandparents, especially her grandfather, were very sick. Case 6 (grandfather) remained positive for SARS-CoV-2 RNA in his sputum specimen in subsequent 2 months. Case 2 (mother) tested negative for SARS-CoV-2 RNA in all samples but positive for IgM and IgG to SARS-CoV-2 since February 9, 2020.Conclusions Presymptomatic transmission TRANS of SARS-CoV-2 causes familial cluster of COVID-19. Exposed to the same source of infection MESHD, family members TRANS present their differences in disease MESHD severity and viral clearance.

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MeSH Disease
Human Phenotype

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