A cluster of health care workers with COVID-19 pneumonia caused by SARS-CoV-2

Abstract

Background: The current outbreak of coronavirus disease 2019 (COVID-19) caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, Hubei, China, spreads across national and international borders.

Methods: We prospectively collected medical records of 14 health care workers (HCWs) who were infected with SARS-CoV-2, in neurosurgery department of Wuhan Union Hospital, China.

Results: Among the 14 HCWs, 12 were conformed cases, the other 2 were suspected cases. Most of them were either exposed to the two index patients or infected coworkers, without knowing they were COVID-19 patients. There were 4 male and 10 female infected HCWs in this cohort, whose mean age was 36 years (SD, 6 years). The main symptoms included myalgia or fatigue (100%), fever (86%) and dry cough (71%). On admission, 79% of infected HCWs showed leucopenia and 43% lymphopenia. Reduced complement C3 could be seen in 57% of the infected HCWs and IL-6 was significantly elevated in 86% of them. The proportion of lymphocytes subsets, concentrations of immunoglobulins, complement C4, IL-2, IL-4, IL-10, TNF-α and IFN-γ were within normal range in these 14 infected HCWs. The most frequent findings on pulmonary computed tomographic images were bilateral multifocal ground-glass opacifications (86%).

Conclusions: Human-to-human transmission of COVID-19 pneumonia has occurred among HCWs, and most of these infected HCWs with confirmed COVID-19 are mild cases. Our data suggest that in the epidemic area of COVID-19, stringent and urgent surveillance and infection-control measures should be implemented to protect doctors and nurses from COVID-19 infection.

Keywords: COVID-19; Health care workers; SARS-CoV-2.

Fig. 1

Results of SARS-CoV-2 detection in health care workers during hospitalization.

Fig. 2

Time of Onset of Symptoms in the Clinical Course. The distribution and lasting days of myalgia or fatigue (A), fever (B), dry cough (C), and diarrhea (D), headache (E), and pharyngalgia (F) in the infected HCWs with COVID-19 pneumonia.

Fig. 3

Pulmonary CTs of two suspected infected HCWs with COVID-19 pneumonia. Transverse chest CT images from Patient 13 (A) showed patchy consolidation in the left lower lobe of lung, (B) the density of consolidation decreases, showing as ground-glass opacity, (C) lesion completely resolved; Transverse chest CT images from Patient 14 (D) showed patchy shadows and ground glass density in the middle lobe of the right lung, (E) the lesion was reduced in the middle lobe of the right lung, and newly small patchy shadows appeared in the left lower lobe of the lung, (F) the lesions in the middle lobe of the right lung and the lower lobe of the left lung were almost resloved, showing as ground-glass opacity.