AUTHOR=Liu Shuyi , Yuan Huanchu , Zhang Bin , Li Wei , You Jingjing , Liu Jing , Zhong Qingyang , Zhang Lu , Chen Luyan , Li Shaolin , Zou Yujian , Zhang Shuixing 

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

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.630802

DOI=10.3389/fmed.2021.630802

ISSN=2296-858X

ABSTRACT=<p><bold>Purpose:</bold> 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.</p><p><bold>Methods:</bold> This retrospective study included 178 symptomatic adult patients with laboratory-confirmed COVID-19. The 178 patients were divided into FC (<italic>n</italic> = 108) and NF (<italic>n</italic> = 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.</p><p><bold>Results:</bold> Compared with the NF group, the FC group had a longer period of exposure (13.1 vs. 8.9 days, <italic>p</italic> &lt; 0.001), viral shedding (21.5 vs. 15.9 days, <italic>p</italic> &lt; 0.001), and hospital stay (39.2 vs. 22.2 days, <italic>p</italic> &lt; 0.001). The FC group showed a higher number of involved lung lobes on admission (3.0 vs. 2.3, <italic>p</italic> = 0.017) and at end-hospitalization (3.6 vs. 1.7, <italic>p</italic> &lt; 0.001) as well as higher sum severity CT scores at end-hospitalization (4.6 vs. 2.7, <italic>p</italic> = 0.005) than did the NF group. Conversely, the FC group had a lower lymphocyte count level (<italic>p</italic> &lt; 0.001) and a significantly lower difference in the number of involved lung lobes (Δnumber) between admission and discharge (<italic>p</italic> &lt; 0.001). Notably, more cases of severe or critical illness were observed in the FC group than in the NF group (<italic>p</italic> = 0.036).</p><p><bold>Conclusions:</bold> 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.</p>