Clinical features of subjects positive for SARS-CoV-2
Patient 1 (father) ﬂew from Wuhan to Haikou on January 22, 2020. He had no history of contact with animals, visits to markets including the Huanan seafood wholesale market in Wuhan, or eating game meat in restaurants. After returning Hainan, he lived with his family including his wife (Patient 2) and three sons (Patient 3,4). Patient 5 (aunt of patient3,4) did not contact with patient 1 but have close contact with the rest of the family. Patient 1 presented with fever, cough and fatigue the next day he went home (Jan 23, 2020). He was confirmed with COVID-19 infection on January 23, 2020. Patients 2-5 stayed at home for quarantine. Relatives 2-4 was diagnosed with SARS-CoV-2 infection 14,17 and 16 days after close contact with patient 1. All of these patients did not present with any clinical symptoms at the time of confirmation. Patient 2 reported fatigue three days after diagnosis. Patient three and four reported cough and diarrhea, respectively on February 9,2020. Patient 5 developed with fever, chest tightness and shortness of breath 14 days after close contact with the relatives (patient 2-4). She was confirmed with SARS-CoV-2 infection on February 6,2020. The incubation period was estimated to be around 14 days.
Of the five patients, three were male and two were female. The age ranged from 33–57 years (Table 1). Only patient 5 had one comorbidity of cardiovascular disease and two had history of fever. The older patients (aged >55 years: patient 1 and 2) developed generalized weakness. Patient 4 had cough. Patients 3 and 4 were younger adults and one of them had diarrhea. They are smokers. Patient 5 also presented with pleuritic chest pain and shortness of breath. Except for patient 5, all four had normal total white blood cell counts and neutrophil cell count. Patient 1 had lymphopenia. Patient 2-5 had normal C-reactive protein, lactate dehydrogenase levels and activated thromboplastin time. All five patients underwent CT examinations at their hospitalization. CT images of patient 2 and 4 did not have significantly positive findings. Patient 1 had negative CT findings on admission. Ten days after symptom onset, small patchy ground glass was observed in the upper lobe of left lung. Patient 3 and patient 5 showed multifocal patchy ground glass opacities and subsegmental areas of consolidation (Figure 2 A, D). These lesions were gradually absorbed with the treatment (Figure 2 B, C; D, E). No other concomitant radiological abnormalities including pleural eﬀusion, lymphadenopathy, or pneumomediastinum were seen.
Treatment and Prognosis
Patient 1 received interferon, antiviral treatment and antibiotic therapy (Moxifloxacin for 14 days). His nasopharyngeal swabs on February 3 and February 5, 2020 testing was negative. He was discharged well from hospital after 14 days hospitalization. Patient 2 was treated with antiviral (for 9 days) and antibiotic therapy (Moxifloxacin for 2 days). She had negative swabs tests on February 11 and 16. She was discharge from hospital on February 17. Patient 3 received antiviral treatment for 6 days and Moxifloxacin for 7 days. He had negative swabs tests on February 15 and 17. He was discharged on February 18,2020. Patient 4 was only treated with interferon (the first 2 days) antiviral treatment for 7 days. He had negative swabs tests on February 15 and 16. He was discharged on February 16,2020. Patient 5 received 2-days of interferon, antiviral and antibiotic treatment for 8 days. She was discharged from hospital after twice negative swabs tests on February 12 and 14.