COVID-19 in a patient with long-term use of glucocorticoids: A study of a familial cluster

Clusters of patients with novel coronavirus disease 2019 (COVID-19) have been successively reported globally. Studies show clear person-to-person transmission. The average incubation period is 2–14 days, and mostly 3–7 days. However, in some patients, this period may be longer. Here, we report a familial cluster of COVID-19 where a 47-year-old woman with long-term use of glucocorticoids did not develop any symptoms within the 14-day quarantine period but was confirmed with COVID-19 by tested positive of antibody on day 40 after she left Wuhan. Almost at the same time, her father and sister were diagnosed with COVID-19. The results suggest that the long-term use of glucocorticoids might cause atypical infections, a long incubation period, and extra transmission of COVID-19. •We report a familial cluster of COVID-19 outside of Wuhan, including 3 confirmed cases out of 5 family members.•The index patient, who had been taking glucocorticoids for 16 years, initially developed atypical symptoms of COVID-19.•The incubation period and shedding time were extremely long in this familial case.•Our results suggest a longer quarantine time for patients with long-term glucocorticoid use.