Multiple Fatalities in a Family Cluster of COVID-19 With Acute Respiratory Distress Syndrome.

Background: Cases of COVID-19 family clusters have been reported across the globe. While disease severity can vary widely, reports of severe infection leading to multiple fatalities within a family are limited. Case Report: Four family members each presented to the emergency department with fever and upper respiratory symptoms. Each individual tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection via nasopharyngeal swab. All individuals developed acute respiratory distress syndrome refractory to conventional medical therapy and subsequently died from their disease. Conclusion: This report describes a familial cluster of fatal COVID-19 infections and suggests a potential genetic predisposition for severe disease, emphasizing the importance of investigating family clusters of severe COVID-19 infection to determine host and viral factors that may predispose to a severe disease course. Such investigations could improve our understanding of the disease and guide preventive measures for at-risk populations.