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Volume 26, Number 8—August 2020
Research Letter

SARS-CoV-2 Transmission from Presymptomatic Meeting Attendee, Germany

DirkJan HijnenComments to Author , Angelo Valerio Marzano, Kilian Eyerich, Corine GeurtsvanKessel, Ana Maria Giménez-Arnau, Pascal Joly, Christian Vestergaard, Michael Sticherling, and Enno Schmidt
Author affiliations: Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands (D. Hijnen, C. GeurtsvanKessel); Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (A.V. Marzano); Università degli Studi di Milano, Milan (A.V. Marzano); Karolinska Institutet, Solna, Sweden (K. Eyerich); Universitat Autònoma de Barcelona, Barcelona, Spain (A.M. Giménez-Arnau); INSERM U—Rouen University Hospital, Rouen, France (P. Joly); Aarhus University Hospital, Aarhus, Denmark (C. Vestergaard); University Hospitals Erlangen, Erlangen, Germany (M. Sticherling); Lübeck Institute of Experimental Dermatology, Lübeck, Germany (E. Schmidt); University of Lübeck, Lübeck (E. Schmidt)

Main Article

Table

Characteristics of all meeting participants, including face-to-face contact with the index patient, SARS-CoV-2 test results, symptoms and illness severity, isolation measures, and further contacts*

Pt no. Country of origin Contact with index patient† PCR results Other test results Age, y/sex Signs/symptoms PGA (date)‡ COVID-19 severity§ Isolation measures Family/other contacts
Pt 1
 Italy
 Index patient
 Feb 22, positive; Mar 9, negative
 NT
 57/M
 Feb 22–Mar 5,
fever, coughing, sneezing, loss of smell and taste. Exanthema developed on day 7
 5 (Feb 25)
 Moderate
 Feb 23–Mar 9, hospital isolation; Mar 9–23, home isolation
 Family: 50/F tested negative; Feb 23–Mar 6, home isolation. Others: 4 hospital clinical staff members tested positive; 80 other contacts in 14-d home isolation, all tested negative
Pt 2
 Spain
 Dinner and taxi
 Feb 27, positive; Mar 13, negative
 NT
 58/F
 Feb 25–Mar 10, slight coughing, fever (for 1 d), GI symptoms, partial loss of smell
 9.5
 Mild
 Feb 27–Mar 12, hospital isolation; Mar 13–27, home isolation
 Family: Husband (59/M) tested positive Feb 28, asymptomatic; mother (86/F) tested positive Mar 4. Others: clinical staff member (F) tested positive, fever and headache; >10 others in home isolation, tested negative
Pt 3
 Denmark
 Neighbor during meeting
 Feb 29, positive
 NT
 49/M
 None
 10
 Asymptomatic
 Feb 27–Mar 13, home isolation
 Family: 45/F, 19/M, 15/F, all tested negative. Others: 12 contacts tested negative
Pt 4
 France
 Dinner
Feb 27, positive; Mar 8, negative
 NT
 60/M
 Feb 24–26, headache, slight coughing
 8.5 (Feb 25)
 Mild
 Feb 29–Mar 2, hospital isolation; Mar 2–10, home isolation
 Family: 62/F tested negative. Others: 1 contact tested positive
Pt 5
 Germany
 Dinner
Feb 28, positive; Mar 6, negative; Mar 9, negative
 ELISA (Euroimmun): Mar 10, positive for IgA and IgG
 50/M
 Feb 28–Mar 3, slight coughing, slight weakness; no fever
 9.5 (Mar 2)
 Mild
 Feb 27–Mar 9, home isolation (with family)
 Family: 46/F, 12/F, 11/F, 9/F, 9/M. 46/F tested negative Mar 6; ILI developed, tested positive Mar 13; severe headache, limb pain, high fever, and dyspnea thereafter for 5 d. Others: 1 contact tested negative, 1 contact tested positive
Pt 6
 Sweden
 Neighbor during meeting
 NT
 ELISA (Euroimmun): Mar 19, positive for IgA and IgG
 40/M
 None
 10
 Asymptomatic
 Feb 29–Mar 7, hotel room isolation
 Family: 41/F, 10/M, 9/F, all tested negative Mar 2. Others: no others tested
Pt 7
 Germany
 No
 Feb 27, positive; Mar 16, negative; Mar 17, negative
 NT
 61/M
 Feb 24–Mar 18, headache, slight coughing, weakness, loss of smell and taste
 6 (Mar 28)
 Moderate
 Feb 27–Mar 12, hospital isolation; Mar 13–, home isolation
 Family: 56/F, 24/F tested negative, home isolation 14 d. Others: 41 contacts in home isolation after contact (14 d); all tested negative
Pt 8
 The Netherlands
 No
 Mar 1, 5, 9, positive; Mar 12, negative
 ELISA (Euroimmun): Mar 7, 18, positive for IgA, neg for IgG
 45/M
 Feb 24 (only), ILI symptoms, fatigue. Feb 24–early April, loss of smell
 6 (Feb 24)
 Moderate
 Feb 27–Mar 8, home isolation (with family)
 Family: 43/F, 13/M and 14/M tested positive (home isolation Feb 29–Mar 8); 43/F ILI symptoms (Feb 27–29), 13/M asymptomatic, 14/M ILI symptoms Feb 25 only.
9/F tested negative (home isolation Feb 29–Mar 11); Others: no others tested or in isolation
Pt 9
 Germany
 Taxi
 NT
 NT
 59/M
 None
 10
 Asymptomatic or NA
 Feb 27–Mar 9, home isolation
 Family; no symptoms, NT. Others: no others tested or in isolation
Pt 10
 Sweden
 No
 Feb 27, positive
 NT
 49/F
 Feb 24–Mar 10, ILI symptoms, GI symptoms, nausea
 5 (Feb 26)
 Moderate
 Feb 27–Mar 5, hospital isolation; Mar 5–18, home isolation
 Family: 55/M, 19/F; no symptoms, NT. Others: unknown
Pt 11
 Germany
 Dinner
 Feb 28, negative
 NT
 36/F
 None
 10
 NA
 Feb 26–Mar 8, home isolation (with family)
 Family: 38/M tested negative. Others: unknown
Pt 12
 Germany
 No
 Feb 27–Mar 8, positive 6 times; Mar 10–12, negative 2 times
 NT
 33/F
 Feb 23–Mar 1, ILI symptoms, headache and limb pain, weakness, sore throat (mild), loss of appetite; loss of smell and taste for 7 more weeks
 3 (Feb 24)
 Moderate
 Feb 26–Mar 10, hospital isolation; Mar 10–12, home isolation
 Family: 33/M tested negative Feb 26/27, Mar 1; home isolation Feb 26–Mar 7. Others: 2 contacts in home isolation until Mar 7; both remained without symptoms, 1 tested negative
Pt 13
 Germany
 No
 Feb 27, positive
 NT
 40/M
 Feb 23–Mar 8, ILI symptoms (cough, limb pain; fever (39.5°C) days 1–4, followed by increased temperature days 5–9
 5 (Feb 24)
 Moderate
 Feb 26–Mar 4, hospital isolation; Mar 4–9, home isolation (with family)
 Family: 42/F, 11/F, both had increased temperature for 1 d (Mar 1); 11/F tested positive Mar 2), negative Mar 6/9; 42/F tested negative (Mar 2); isolation ongoing even after 2nd negative test. Others: unknown
Pt 14 Germany No Feb 27, positive; Mar 5, negative; Mar 6, negative NT 45/F Feb 23–Mar 6, headache and limb pain, fatigue; no fever 5 (Feb 27) Moderate Feb 27–Mar 7, hospital isolation Family: 37/F, no symptoms, tested negative (Feb 27–Mar 7). Others: 15 contacts in home isolation; 14/15 no symptoms, 1 contact had symptoms develop and tested positive

*Last updated on April 20, 2020. All dates are for 2020. GI, gastrointestinal; ILI, influenza-like; NA, not applicable; NT, not tested; PGA, patient global assessment; Pt, participant.
†Face-to-face contact with the index patient (Pt1) lasting >5 min.
‡Severity of COVID-19 symptoms quantified by the patients related to the time with the most severe symptoms from 1–10 (1, close to death; 10, full health).
§Mild, PGA ≥8; moderate, PGA <8 but no hospitalization required.

Main Article

Page created: May 11, 2020
Page updated: July 19, 2020
Page reviewed: July 19, 2020
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