Liu Shuyi, Yuan Huanchu, Zhang Bin, Li Wei, You Jingjing, Liu Jing, Zhong Qingyang, Zhang Lu, Chen Luyan, Li Shaolin, Zou Yujian, Zhang Shuixing
Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of Radiology, Dongguan People's Hospital, Dongguan, China.
Front Med (Lausanne). 2021 Apr 15;8:630802. doi: 10.3389/fmed.2021.630802. eCollection 2021.
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. This retrospective study included 178 symptomatic adult patients with laboratory-confirmed COVID-19. The 178 patients were divided into FC ( = 108) and NF ( = 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. Compared with the NF group, the FC group had a longer period of exposure (13.1 vs. 8.9 days, < 0.001), viral shedding (21.5 vs. 15.9 days, < 0.001), and hospital stay (39.2 vs. 22.2 days, < 0.001). The FC group showed a higher number of involved lung lobes on admission (3.0 vs. 2.3, = 0.017) and at end-hospitalization (3.6 vs. 1.7, < 0.001) as well as higher sum severity CT scores at end-hospitalization (4.6 vs. 2.7, = 0.005) than did the NF group. Conversely, the FC group had a lower lymphocyte count level ( < 0.001) and a significantly lower difference in the number of involved lung lobes (Δnumber) between admission and discharge ( < 0.001). Notably, more cases of severe or critical illness were observed in the FC group than in the NF group ( = 0.036). 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.
本研究旨在比较2019冠状病毒病(COVID-19)肺炎家族聚集性(FC)患者和非家族性(NF)患者的临床特征、实验室检查结果及胸部计算机断层扫描(CT)表现。这项回顾性研究纳入了178例有症状的实验室确诊COVID-19成年患者。这178例患者被分为FC组(n = 108)和NF组(n = 70)。家庭中至少有两例确诊COVID-19病例的患者被归入FC组。比较了两组之间的临床和实验室特征以及入院时和出院时的胸部CT表现。与NF组相比,FC组的暴露时间更长(13.1天对8.9天,P < 0.001)、病毒脱落时间更长(21.5天对15.9天,P < 0.001)以及住院时间更长(39.2天对22.2天,P < 0.001)。FC组在入院时(3.0个对2.3个,P = 0.017)和出院时(3.6个对1.7个,P < 0.001)累及肺叶数量更多,且出院时的总严重程度CT评分更高(4.6分对2.7分,P = 0.005)。相反,FC组淋巴细胞计数水平更低(P < 0.001),且入院和出院之间累及肺叶数量的差异(Δ数量)显著更小(P < 0.001)。值得注意的是,FC组中观察到的重症或危重症病例比NF组更多(P = 0.036)。FC组患者的临床病程和结局比NF组患者更差;因此,治疗期间的密切监测和出院后的随访对家族性感染患者有益。