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Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing study.
J Infect. 2020 06; 80(6):e1-e13.JI

Abstract

BACKGROUND

The outbreak of coronavirus-disease-2019 (COVID-19) has rapidly spread to many places outside Wuhan. Previous studies on COVID-19 mostly included older hospitalized-adults. Little information on infectivity among and characteristics of youngsters with COVID-19 is available.

METHODS

A cluster of 22 close-contacts of a 22-year-old male (Patient-Index) including youngsters with laboratory-confirmed COVID-19 and hospitalized close-contacts testing negative for severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) in Anhui Province, China was prospectively-traced.

RESULTS

Since January 23, 2020, we enrolled a cluster of eight youngsters with COVID-19 (median age [range], 22 [16-23] years; six males) originating from Patient-Index returning from Wuhan to Hefei on January 19. Patient-Index visited his 16-year-old female cousin in the evening on his return, and met 15 previous classmates in a get-together on January 21. He reported being totally asymptomatic and were described by all his contacts as healthy on January 19-21. His very first symptoms were itchy eyes and fever developed at noon and in the afternoon on January 22, respectively. Seven youngsters (his cousin and six classmates) became infected with COVID-19 after a-few-hour-contact with Patient-Index. None of the patients and contacts had visited Wuhan (except Patient-Index), or had any exposure to wet-markets, wild-animals, or medical-institutes within three months. For affected youngsters, the median incubation-period was 2 days (range, 1-4). The median serial-interval was 1 day (range, 0-4). Half or more of the eight COVID-19-infected youngsters had fever, cough, sputum production, nasal congestion, and fatigue on admission. All patients had mild conditions. Six patients developed pneumonia (all mild; one bilateral) on admission. As of February 20, four patients were discharged.

CONCLUSIONS

SARS-CoV-2-infection presented strong infectivity during the incubation-period with rapid transmission in this cluster of youngsters outside Wuhan. COVID-19 developed in these youngsters had fast onset and various nonspecific atypical manifestations, and were much milder than in older patients as previously reported.

Authors+Show Affiliations

Department of General Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China. Electronic address: huangleizhenting@126.com.Department of Quarantine Ward, East District of First Affiliated Hospital of Anhui Medical University (Feidong People's Hospital), Hefei, Anhui Province, China; Graduate School, Soochow University, Suzhou, Jiangsu Province, China.Department of Academic Research, The First People's Hospital of Hefei, Hefei, Anhui Province, China.Department of General Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China.Department of Quarantine Ward, East District of First Affiliated Hospital of Anhui Medical University (Feidong People's Hospital), Hefei, Anhui Province, China.Department of Quarantine Ward, East District of First Affiliated Hospital of Anhui Medical University (Feidong People's Hospital), Hefei, Anhui Province, China.Department of Emergency Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.Department of Clinical Laboratory Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China. Electronic address: xyhong1964@163.com.Department of Respiratory and Critical Care Medicine, East District of First Affiliated Hospital of Anhui Medical University (Feidong People's Hospital), Hefei 231600, Anhui Province, China. Electronic address: 2396476405@qq.com.Department of General Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China. Electronic address: amanxu@163.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32283156

Citation

Huang, Lei, et al. "Rapid Asymptomatic Transmission of COVID-19 During the Incubation Period Demonstrating Strong Infectivity in a Cluster of Youngsters Aged 16-23 Years Outside Wuhan and Characteristics of Young Patients With COVID-19: a Prospective Contact-tracing Study." The Journal of Infection, vol. 80, no. 6, 2020, pp. e1-e13.
Huang L, Zhang X, Zhang X, et al. Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing study. J Infect. 2020;80(6):e1-e13.
Huang, L., Zhang, X., Zhang, X., Wei, Z., Zhang, L., Xu, J., Liang, P., Xu, Y., Zhang, C., & Xu, A. (2020). Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing study. The Journal of Infection, 80(6), e1-e13. https://doi.org/10.1016/j.jinf.2020.03.006
Huang L, et al. Rapid Asymptomatic Transmission of COVID-19 During the Incubation Period Demonstrating Strong Infectivity in a Cluster of Youngsters Aged 16-23 Years Outside Wuhan and Characteristics of Young Patients With COVID-19: a Prospective Contact-tracing Study. J Infect. 2020;80(6):e1-e13. PubMed PMID: 32283156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing study. AU - Huang,Lei, AU - Zhang,Xiuwen, AU - Zhang,Xinyue, AU - Wei,Zhijian, AU - Zhang,Lingli, AU - Xu,Jingjing, AU - Liang,Peipei, AU - Xu,Yuanhong, AU - Zhang,Chengyuan, AU - Xu,Aman, Y1 - 2020/04/10/ PY - 2020/03/02/received PY - 2020/03/03/accepted PY - 2020/4/14/pubmed PY - 2020/5/21/medline PY - 2020/4/14/entrez KW - COVID-19 KW - Characteristics KW - Cluster of youngsters KW - Incubation period KW - Infectivity KW - Outside Wuhan KW - Prospective contact-tracing study KW - Rapid transmission SP - e1 EP - e13 JF - The Journal of infection JO - J Infect VL - 80 IS - 6 N2 - BACKGROUND: The outbreak of coronavirus-disease-2019 (COVID-19) has rapidly spread to many places outside Wuhan. Previous studies on COVID-19 mostly included older hospitalized-adults. Little information on infectivity among and characteristics of youngsters with COVID-19 is available. METHODS: A cluster of 22 close-contacts of a 22-year-old male (Patient-Index) including youngsters with laboratory-confirmed COVID-19 and hospitalized close-contacts testing negative for severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) in Anhui Province, China was prospectively-traced. RESULTS: Since January 23, 2020, we enrolled a cluster of eight youngsters with COVID-19 (median age [range], 22 [16-23] years; six males) originating from Patient-Index returning from Wuhan to Hefei on January 19. Patient-Index visited his 16-year-old female cousin in the evening on his return, and met 15 previous classmates in a get-together on January 21. He reported being totally asymptomatic and were described by all his contacts as healthy on January 19-21. His very first symptoms were itchy eyes and fever developed at noon and in the afternoon on January 22, respectively. Seven youngsters (his cousin and six classmates) became infected with COVID-19 after a-few-hour-contact with Patient-Index. None of the patients and contacts had visited Wuhan (except Patient-Index), or had any exposure to wet-markets, wild-animals, or medical-institutes within three months. For affected youngsters, the median incubation-period was 2 days (range, 1-4). The median serial-interval was 1 day (range, 0-4). Half or more of the eight COVID-19-infected youngsters had fever, cough, sputum production, nasal congestion, and fatigue on admission. All patients had mild conditions. Six patients developed pneumonia (all mild; one bilateral) on admission. As of February 20, four patients were discharged. CONCLUSIONS: SARS-CoV-2-infection presented strong infectivity during the incubation-period with rapid transmission in this cluster of youngsters outside Wuhan. COVID-19 developed in these youngsters had fast onset and various nonspecific atypical manifestations, and were much milder than in older patients as previously reported. SN - 1532-2742 UR - https://www.unboundmedicine.com/medline/citation/32283156/Rapid_asymptomatic_transmission_of_COVID_19_during_the_incubation_period_demonstrating_strong_infectivity_in_a_cluster_of_youngsters_aged_16_23_years_outside_Wuhan_and_characteristics_of_young_patients_with_COVID_19:_A_prospective_contact_tracing_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-4453(20)30117-1 DB - PRIME DP - Unbound Medicine ER -