Objective: This study investigated the influence of Coronavirus Disease 2019 (COVID-19) on lung function in early convalescence phase. Methods: A retrospective study of COVID-19 patients at the Fifth Affiliated Hospital of Sun Yat-sen University were conducted, with serial assessments including lung volumes (TLC), spirometry (FVC, FEV1), lung diffusing capacity for carbon monoxide (DLCO),respiratory muscle strength, 6-min walking distance (6MWD) and high resolution CT being collected at 30 days after discharged.Results: Fifty-seven patients completed the serial assessments. There were 40 non-severe cases and 17 severe cases. Thirty-one patients (54.3%) had abnormal CT findings. Abnormalities were detected in the pulmonary function tests in 43 (75.4%) of the patients. Six (10.5%), 5(8.7%), 25(43.8%) 7(12.3%), and 30 (52.6%) patients had FVC, FEV1, FEV1/FVC ratio, TLC, and DLCO values less than 80% of predicted values, respectively. 28 (49.1%) and 13 (22.8%) patients had PImax and PEmax values less than 80% of the corresponding predicted values. Compared with non-severe cases, severe patients showed higher incidence of DLCO impairment (75.6%vs42.5%, p = 0.019), higher lung total severity score (TSS) and R20, and significantly lower percentage of predicted TLC and 6MWD. No significant correlation between TSS and pulmonary function parameters was found during follow-up visit. Conclusion: Impaired diffusing-capacity, lower respiratory muscle strength, and lung imaging abnormalities were detected in more than half of the COVID-19 patients in early convalescence phase. Compared with non-severe cases, severe patients had a higher incidence of DLCO impairment and encountered more TLC decrease and 6MWD decline.

Jing Liu) J o u r n a l P r e -p r o o f Journal Pre-proof others (21 participants), including Department of Pulmonary and Critical Care Medicine (PCCM), Department of Cardiology and General ICU, from 3 to 21, February 2020 (Figure 1). As illustrated, several staff were experiencing clinically signficiant depressive symptoms according to established thresholds [3]. There were no significant differences in scores between staff in COVID-19-associated andother J o u r n a l P r e -p r o o f Journal Pre-proof 3 departments ( Figure 1A, t-test, t SDS =0.77, df SDS =95, P SDS =0.44; t-test, t SAS =1.03, df SAS =95, P SAS =0.31). Younger (age≤30) medical staff had higher SDS scores than older staff but this difference was not statistically signficant. (Figure 1 B, t-test, t SDS =1.64, df SDS =83, P SDS =0.11; t-test, t SAS =0.31, df SAS =83, P SAS =0.76). (Table 1) Our results are a reminder not to neglect the mental health of the other medical department staff during the pandemic, including younger medical staff. Intervention including daily living supplies, pre-job training, leisure activities and psychological counseling like the Second Xiangya Hospital of Central South University advised, were also ongoing in our hospital [4]. Reasonable resting for medical staff may also help relieve stress according to our experience. It's essential for medical staff to keep physical and psychological health during our struggle of COVID-19. SDS and SAS were simple = tools to monitoring the self-mental health [5]. J o u r n a l P r e -p r o o f Journal Pre-proof 4 Figure1 Raw scores of various departments or ages. (A) Orange is the medical staffs of COVID-19-associated departments and the blue represents other departments. Dots represents each doctor or nurse raw score. SDS raw scores are on the left of the dashed line and the SAS J o u r n a l P r e -p r o o f Journal Pre-proof

We found that the overall second infection rate of SARS-COV-2 was 32.4% within household. The estimated median incubation period and serial interval were 4.3 days and 5.1 days, respectively. Early isolation of patients and contact investigation should be initiated urgently. AbstractBackground: To illustrate the extent of transmission, identify affecting risk factors and estimate epidemiological modeling parameters of SARS-CoV-2 in household setting. Methods:We enrolled 35 confirmed index cases and their 148 household contacts, January 2020-February 2020, in Zhuhai, China. All participants were interviewed and asked to complete questionnaires. Household contacts were then prospectively followed active symptom monitoring through the 21-day period and nasopharyngeal and/or oropharyngeal swabs were collected at 3-7 days intervals. Epidemiological, demographic and clinical data (when available) were collected. Results:Assuming that all these secondary cases were infected by their index cases, the second infection rate (SIR) in household context is 32.4% (95% confidence interval [CI] 22.4%-44.4%), with 10.4% of secondary cases being asymptomatic. Multivariate analysis showed that household contacts with underlying medical conditions, a history of direct exposure to Wuhan and its surrounding areas, and shared vehicle with an index patient were associated with higher susceptibility. Household members without protective measures after illness onset of the index patient seem to increase the risk for SARS-CoV-2 infection. The median incubation period and serial interval within household were estimated to be 4.3 days (95% CI; 3.4 to 5.3 days) and 5.1 days (95% CI; 4.3 to 6.2 days), respectively. Conclusion:Early isolation of patients with COVID-19 and prioritizing rapid contact investigation, followed by active symptom monitoring and periodic laboratory evaluation, should be initiated immediately after confirming patients to address the underlying determinants driving the continuing pandemic.

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