Clinical characteristics of COVID-19 in family clusters: a systematic review

摘要

Background Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has spread around the world and reports of children during early epidemic period showed features of family clusters.The aim of this study is to assess clinical profiles of COVID-19 in family clusters with children.Methods We performed a systematic literature review of English database(PubMed,Web of Science)and Chinese database(“www.cnki.net”,“www.cqvip.com”and“www.Wanfangdata.com.cn”)to identify papers on family clusters of COVID-19 with children and their family members.Results Eighteen studies involving 34 children and 98 adults from 28 families were included.Fever,cough and ground-grass opacity change of chest computed tomography(CT)were the dominant features,whereas proportion of asymptomatic infections for children was higher than adults with statistical significance(32.4%and 13.3%,respectively,P<0.05).Median time of longer incubation period(10 days)and shorter duration of pharyngeal swab nucleic acid test positive period(11 days)were seen in children than adults(7 and 17 days,respectively)with statistical significance(P<0.05).There were statistically significant differences in lymphopenia,increased C-reactive protein and abnormal chest CT between children and adult patients(P<0.05).Twenty-seven families reported adults as first case of COVID-19 in family clusters.Conclusions The same virus strain can cause milder disease in children compared with their caregivers.Children of COVID-19 were infected by adults in family during the early epidemic period.Asymptomatic patients can transmit the virus.