First 12 patients with coronavirus disease 2019 (COVID-19) in the United States

Stephanie A. Kujawski; Karen K Wong; Jennifer P. Collins; Lauren Epstein; Marie E. Killerby; Claire M. Midgley; Glen R. Abedi; N. Seema Ahmed; Olivia Almendares; Francisco N. Alvarez; Kayla N. Anderson; Sharon Balter; Vaughn Barry; Karri Bartlett; Karlyn Beer; Michael A. Ben-Aderet; Isaac Benowitz; Holly Biggs; Alison M. Binder; Stephanie R. Black; Brandon Bonin; Catherine M. Brown; Hollianne Bruce; Jonathan Bryant-Genevier; Alicia Budd; Diane Buell; Rachel Bystritsky; Jordan Cates; E. Matt Charles; Kevin Chatham-Stephens; Nora Chea; Howard Chiou; Demian Christiansen; Victoria Chu; Sara Cody; Max Cohen; Erin Conners; Aaron Curns; Vishal Dasari; Patrick Dawson; Traci DeSalvo; George Diaz; Matthew Donahue; Suzanne Donovan; Lindsey M. Duca; Keith Erickson; Mathew D. Esona; Suzanne Evans; Jeremy Falk; Leora R. Feldstein; Martin Fenstersheib; Marc Fischer; Rebecca Fisher; Chelsea Foo; Marielle J. Fricchione; Oren Friedman; Alicia M. Fry; Romeo R. Galang; Melissa M. Garcia; Susa I. Gerber; Graham Gerrard; Isaac Ghinai; Prabhu Gounder; Jonathan Grein; Cheri Grigg; Jeffrey D. Gunzenhauser; Gary I. Gutkin; Meredith Haddix; Aron J. Hall; George Han; Jennifer Harcourt; Kathleen Harriman; Thomas Haupt; Amber Haynes; Michelle Holshue; Cora Hoover; Jennifer C. Hunter; Max W. Jacobs; Claire Jarashow; Michael A. Jhung; Kiran Joshi; Talar Kamali; Shifaq Kamili; Lindsay Kim; Moon Kim; Jan King; Hannah L. Kirking; Amanda Kita-Yarbro; Rachel Klos; Miwako Kobayashi; Anna Kocharian; Kenneth K. Komatsu; Ram Koppaka; Jennifer E. Layden; Yan Li; Scott Lindquist; Stephen Lindstrom; Ruth Link-Gelles; Joana Lively; Michelle Livingston; Kelly Lo; Jennifer Lo; Xiaoyan Lu; Brian Lynch; Larry Madoff; Lakshmi Malapati; Gregory Marks; Mariel Marlow; Glenn E. Mathisen; Nancy McClung; Olivia McGovern; Tristan D. McPherson; Mitali Mehta; Audrey Meier; Lynn Mello; Sung-sil Moon; Margie Morgan; Ruth N. Moro; Janna' Murray; Rekha Murthy; Shannon Novosad; Sara E. Oliver; Jennifer O'Shea; Massimo Pacilli; Clinton R. Paden; Mark A. Pallansch; Manisha Patel; Sajan Patel; Isabel Pedraza; Satish K. Pillai; Talia Pindyck; Ian Pray; Krista Queen; Nichole Quick; Heather Reese; Brian Rha; Heather Rhodes; Susan Robinson; Philip Robinson; Melissa Rolfes; Janell Routh; Rachel Rubin; Sarah L. Rudman; Senthilkumar K. Sakthivel; Sarah Scott; Christopher Shepherd; Varun Shetty; Ethan A. Smith; Shanon Smith; Bryan Stierman; William Stoecker; Rebecca Sunenshine; Regina Sy-Santos; Azaibi Tamin; Ying Tao; Dawn Terashita; Natalie J. Thornburg; Suxiang Tong; Elizabeth Traub; Ahmet Tural; Anna Uehara; Timothy M. Uyeki; Grace Vahey; Jennifer R. Verani; Elsa Villarino; Megan Wallace; Lijuan Wang; John T. Watson; Matthew Westercamp; Brett Whitaker; Sarah Wilkerson; Rebecca C. Woodruff; Jonathan M. Wortham; Tiffany Wu; Amy Xie; Anna Yousaf; Matthew Zahn; Jing Zhang

We describe the first 12 patients with confirmed COVID-19 in the United States, including clinical course of the first 7 hospitalized patients. Nine patients had traveled to Wuhan City, the epicenter of the outbreak, one had traveled to China but not to Hubei Province, and two had close contact with a patient with confirmed COVID-19 in the United States, representing domestic human-to-human transmission. Illness ranged from mild to moderately severe, and hospitalized patients showed signs of clinical worsening in the second week. All patients recovered or are improving, and three patients tolerated treatment with the investigational antiviral remdesivir. SARS-CoV-2 RNA was detected in upper and lower respiratory specimens, stool, and serum. The highest viral RNA levels were detected in upper respiratory tract specimens, typically during the first week of illness. SARS-CoV-2 was cultured from the initial respiratory specimens of mild and moderately ill patients. Viral RNA was still detected after reported symptom resolution for seven patients. SARS-CoV-2 genome sequencing and phylogenetic for use under a CC0 license.