Features of the COVID-19 clinical course in doctors in the family cluster of infection. Description of a clinical case

ABSTRACT

This case has several features. First of all, it covers the clinical course of Covid-19 disease in a family cluster, everyone of this family has a different medical specialization. This makes it possible to observe the case constantly. Diaries were kept by all family members. Secondly, there are two age groups in the cluster 24-30 years old (let’s call them “Children”) and 50-60 years old (let’s call them “Parents”). This allowed us to compare the course of the disease depending on the age and the presence of chronic diseases. On one hand the presence of a dentist in the cluster made this observation unique. We were able to compare change in general condition with the change in dental status. Also important opportunity for the polymerase chain reaction to be conducted weekly at the “Children’s” work place. In retrospect we can say that the precursors of the disease appeared earlier than the positive result of laboratory diagnostics. The first confirmed contacts with infected patients occurred in the “Children” group. Due to this fact it was possible to assume about the way of transmission of the SARS-Cov-2 virus to “Parents”. It should be noted that the disease wasn’t one-stage for all family members, despite everyone daily contact. With 2 days in between, “Children” got sick. After 7 and 11 days, “Parents” fell ill. This fact raised a question of a “reference point”. Which symptoms really show the beginning of the disease? The disease severity was different one “parent” - mild, second “parent” - moderate, one “child” - moderate, second “child” - severe. All of the family members recovered. The diagnoses were confirmed by laboratory tests, and pneumonia was diagnosed based on multislice computed tomography. Diagnostics, treatment and quarantine measures met the standards of the “Temporary clinical recommendations” 6 revision of 24.05.2020 of the Ministry of health of the Russian Federation, methodological recommendations MR 3.1.0170-20 with amendments No 1 “Epidemiology and prevention of COVID-19". © 2020, Yerevan State Medical University. All rights reserved.