Epidemiologic and Clinical Characteristics of 26 Cases of COVID-19 Arising from Patient-to-Patient Transmission in Liaocheng, China

Wang, Lizhen; Duan, Yueting; Zhang, Wenming; Liang, Juan; Xu, Jianxiang; Zhang, Yongqing; Wu, Changgang; Xu, Yangling; Li, Hua

We report here a cohort of 25 cases of laboratory-confirmed COVID-19 at our hospital caused by patient-to-patient transmission of 2019-nCoV. As a result of consistent and effective prevention and treatment measures, all of the cases have thus far been mild. However, as of February 12, 2020, the number of patients with COVID-19 has far exceeded the observed rates of SARS and MERS. 1 This may be attributable to a failure to identify the etiologic agent early on and the ability of 2019-nCoV to rapidly spread from person to ) person, rather than greater infectivity of the virus itself. 10, 11 In contrast to previous reports, most patients (24/26) had not been in close contact with individuals from Wuhan. 12 Additionally, 11 patients or their family members worked at the same supermarket, suggesting active viral transmission in a location frequented by a large number of people. Close monitoring is essential for preventing the large-scale spread of the virus in such places. 13 Most of the infected patients were healthy adults; exceptions were 1 patient aged 77 years and 2 students aged 15 and 10 years. The demographic data also diverged from previous research, which could be related to the epidemiologic characteristics of our cohort such as familial aggregation and patient-to-patient transmission, rather than a lower resistance to infection or impaired immune function. 13 However, the clinical features and laboratory test results were similar to those reported in a study of 99 cases of 2019-nCoV-related pneumonia in Wuhan. 4 Although our study was limited by a lack of critically ill patients and short admission times, our findings nonetheless provide evidence of person-to-person transmission of 2019-nCoV within a family home or in densely populated public places such as a supermarket. Stricter precautions are necessary to prevent 2019-nCoV transmission at the early stage of infection, even outside of Wuhan.