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Investigation of One Familial Cluster of COVID-19 in Taiwan: Differentiation of Genetic Variation Among Isolates and Implications for Epidemiological Investigation and Surveillance by Genomic Assay

Authors Jian MJ, Chung HY, Chang CK, Hsieh SS, Lin JC, Yeh KM, Chen CW, Chang FY, Chiu SK, Hung KS, Liu MT, Yang JR, Perng CL, Shang HS

Received 22 December 2020

Accepted for publication 16 February 2021

Published 11 March 2021 Volume 2021:14 Pages 971—977

DOI https://doi.org/10.2147/IDR.S298451

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Sahil Khanna


Ming-Jr Jian,1 Hsing-Yi Chung,1 Chih-Kai Chang,1 Shan-Shan Hsieh,1 Jung-Chung Lin,2 Kuo-Ming Yeh,2 Chien-Wen Chen,3 Feng-Yee Chang,2 Sheng-Kang Chiu,2 Kuo-Sheng Hung,4 Ming-Tsan Liu,5 Ji-Rong Yang,5 Cherng-Lih Perng,1 Hung-Sheng Shang1

1Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China; 2Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China; 3Division of Pulmonary and Critical Care Medicine, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China; 4Center for Precision Medicine and Genomics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China; 5Centers for Disease Control, Taipei, Taiwan, Republic of China

Correspondence: Hung-Sheng Shang
Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, Neihu, Taipei, 114, Taiwan, Republic of China
Tel +886920713130
Fax +886287927226
Email [email protected]

Abstract: The COVID-19 pandemic has caused a global public health crisis. Taiwan experienced two waves of imported cases of coronavirus disease 2019 (COVID-19), first from China in January to late February, 2020 then from other countries starting in early March. As of Dec 14, 2020, 733 cases have been reported in Taiwan, with cases of entire families being infected. This study aimed to investigate the clinical characteristics and differentiation of genetic variation among isolates from a cluster of familial COVID-19 infection. The parents had pneumonia (Case 14, father, and Case 15, mother), the elder son (Case 17) had mild cough, and the younger son (Case 18) was asymptomatic. In this study, four full viral genomes were sequenced by Illumina sequencing directly from specimens. Phylogenetic tree analysis revealed that these sequences came from Italy, not China, indicating that no major strain has been circulating in Taiwan. Several novel mutations were observed in the asymptomatic patient, such as nsp2, nsp12, and nsp14. These mutations may be associated with the severity of COVID-19 infection.

Keywords: COVID-19, SARS-CoV-2, imported family infections, whole-genome sequencing, phylogenetic analysis

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