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Nosocomial outbreak of COVID-19 pneumonia in Wuhan, China.
Eur Respir J. 2020 06; 55(6)ER

Abstract

BACKGROUND

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infected over 3300 healthcare workers in early 2020 in China. Little information is known about nosocomial infections of healthcare workers in the initial period. We analysed data from healthcare workers with nosocomial infections in Wuhan Union Hospital (Wuhan, China) and their family members.

METHODS

We collected and analysed data on exposure history, illness timelines and epidemiological characteristics from 25 healthcare workers with laboratory-confirmed coronavirus disease 2019 (COVID-19) and two healthcare workers in whom COVID-19 was highly suspected, as well as 10 of their family members with COVID-19, between 5 January and 12 February 2020. The demographics and clinical features of the 35 laboratory-confirmed cases were investigated and viral RNA of 12 cases was sequenced and analysed.

RESULTS

Nine clusters were found among the patients. All patients showed mild to moderate clinical manifestation and recovered without deterioration. The mean period of incubation was 4.5 days, the mean±sd clinical onset serial interval (COSI) was 5.2±3.2 days, and the median virus shedding time was 18.5 days. Complete genomic sequences of 12 different coronavirus strains demonstrated that the viral structure, with small irrelevant mutations, was stable in the transmission chains and showed remarkable traits of infectious traceability.

CONCLUSIONS

SARS-CoV-2 can be rapidly transmitted from person to person, regardless of whether they have symptoms, in both hospital settings and social activities, based on the short period of incubation and COSI. The public health service should take practical measures to curb the spread, including isolation of cases, tracing close contacts, and containment of severe epidemic areas. Besides this, healthcare workers should be alert during the epidemic and self-quarantine if self-suspected of infection.

Authors+Show Affiliations

Dept of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Equal contributors.Dept of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Equal contributors.Dept of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China. Equal contributors.School of Urban Design, Wuhan University, Wuhan, China.Dept of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China.Dept of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Dept of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Dept of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Dept of Respiratory, Critical Care, and Sleep Medicine, Xiang'an Hospital of Xiamen University, Xiamen, China.Dept of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Dept of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China.Dept of Anaesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Dept of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Dept of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Dept of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China.Beijing CapitalBio Medical Laboratory, Beijing, China.Beijing CapitalBio Medical Laboratory, Beijing, China.Beijing CapitalBio Medical Laboratory, Beijing, China.Beijing CapitalBio Medical Laboratory, Beijing, China.Beijing CapitalBio Medical Laboratory, Beijing, China.Beijing CapitalBio Medical Laboratory, Beijing, China.Beijing CapitalBio Medical Laboratory, Beijing, China.National Engineering Research Center for Beijing Biochip Technology, Beijing, China. CapitalBio Corporation, Beijing, China.National Engineering Research Center for Beijing Biochip Technology, Beijing, China. CapitalBio Corporation, Beijing, China.Dept of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.Dept of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. These authors are joint principal authors.Dept of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China zcgao@bjmu.edu.cn. These authors are joint principal authors.

Pub Type(s)

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

Language

eng

PubMed ID

32366488

Citation

Wang, Xiaorong, et al. "Nosocomial Outbreak of COVID-19 Pneumonia in Wuhan, China." The European Respiratory Journal, vol. 55, no. 6, 2020.
Wang X, Zhou Q, He Y, et al. Nosocomial outbreak of COVID-19 pneumonia in Wuhan, China. Eur Respir J. 2020;55(6).
Wang, X., Zhou, Q., He, Y., Liu, L., Ma, X., Wei, X., Jiang, N., Liang, L., Zheng, Y., Ma, L., Xu, Y., Yang, D., Zhang, J., Yang, B., Jiang, N., Deng, T., Zhai, B., Gao, Y., Liu, W., ... Gao, Z. (2020). Nosocomial outbreak of COVID-19 pneumonia in Wuhan, China. The European Respiratory Journal, 55(6). https://doi.org/10.1183/13993003.00544-2020
Wang X, et al. Nosocomial Outbreak of COVID-19 Pneumonia in Wuhan, China. Eur Respir J. 2020;55(6) PubMed PMID: 32366488.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nosocomial outbreak of COVID-19 pneumonia in Wuhan, China. AU - Wang,Xiaorong, AU - Zhou,Qiong, AU - He,Yukun, AU - Liu,Lingbo, AU - Ma,Xinqian, AU - Wei,Xiaoshan, AU - Jiang,Nanchuan, AU - Liang,Limei, AU - Zheng,Yali, AU - Ma,Ling, AU - Xu,Yu, AU - Yang,Dong, AU - Zhang,Jianchu, AU - Yang,Bohan, AU - Jiang,Ning, AU - Deng,Tao, AU - Zhai,Bingbing, AU - Gao,Yang, AU - Liu,Wenxuan, AU - Bai,Xinghua, AU - Pan,Tao, AU - Wang,Guoqing, AU - Chang,Yujun, AU - Zhang,Zhi, AU - Shi,Huanzhong, AU - Ma,Wan-Li, AU - Gao,Zhancheng, Y1 - 2020/06/04/ PY - 2020/03/04/received PY - 2020/04/08/accepted PY - 2020/5/6/pubmed PY - 2020/6/13/medline PY - 2020/5/6/entrez JF - The European respiratory journal JO - Eur Respir J VL - 55 IS - 6 N2 - BACKGROUND: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infected over 3300 healthcare workers in early 2020 in China. Little information is known about nosocomial infections of healthcare workers in the initial period. We analysed data from healthcare workers with nosocomial infections in Wuhan Union Hospital (Wuhan, China) and their family members. METHODS: We collected and analysed data on exposure history, illness timelines and epidemiological characteristics from 25 healthcare workers with laboratory-confirmed coronavirus disease 2019 (COVID-19) and two healthcare workers in whom COVID-19 was highly suspected, as well as 10 of their family members with COVID-19, between 5 January and 12 February 2020. The demographics and clinical features of the 35 laboratory-confirmed cases were investigated and viral RNA of 12 cases was sequenced and analysed. RESULTS: Nine clusters were found among the patients. All patients showed mild to moderate clinical manifestation and recovered without deterioration. The mean period of incubation was 4.5 days, the mean±sd clinical onset serial interval (COSI) was 5.2±3.2 days, and the median virus shedding time was 18.5 days. Complete genomic sequences of 12 different coronavirus strains demonstrated that the viral structure, with small irrelevant mutations, was stable in the transmission chains and showed remarkable traits of infectious traceability. CONCLUSIONS: SARS-CoV-2 can be rapidly transmitted from person to person, regardless of whether they have symptoms, in both hospital settings and social activities, based on the short period of incubation and COSI. The public health service should take practical measures to curb the spread, including isolation of cases, tracing close contacts, and containment of severe epidemic areas. Besides this, healthcare workers should be alert during the epidemic and self-quarantine if self-suspected of infection. SN - 1399-3003 UR - https://www.unboundmedicine.com/medline/citation/32366488/Nosocomial_outbreak_of_COVID_19_pneumonia_in_Wuhan_China_ L2 - http://erj.ersjournals.com:4040/lookup/pmidlookup?view=long&pmid=32366488 DB - PRIME DP - Unbound Medicine ER -