ABSTRACT
Objectives
To analyze characteristics of asymptomatic/pres-ymptomatic patients with SARS-CoV-2 infection.
Methods
Chest computed tomography(CT), indicators for organ and coagulation function, inflammation cytokines, of asymptomatic/pre-symptomatic patients with SARS-CoV-2 infection were retrospectively analyzed in Zhongnan Hospital of Wuhan University from 20 December 2019, to 8 March 2020.
Results
The proportion of normal chest CT in asymptomatic and pre-symptomatic patients with SARS-CoV-2 infection were 35.4% (17/48) and 3.3%(2/61), respectively (P< 0.001). In 17 asymptomatic patients, their images of chest CT maintained normal during the whole course of diseases, while the normal images of chest CT in 2 pre-symptomatic patients progressed to abnormal later (P< 0.001). All the six asymptomatic patients with SARS-CoV-2 infection maintained unilateral lesion, while the proportion was 29.4%(5/17) in pre-symptomatic patients(P= 0.003). Compared with asymptomatic patients, pre-symptomatic COVID-19 patients had worse levels of Lymphocyte count (P= 0.001), Albumin (P= 0.045), Aspartate aminotransferase (P= 0.044), γ-glutamyl transpeptadase (P= 0.016), Globulin (P= 0.036), Creatinine (P= 0.021), Lactate dehydrogenase (P= 0.008), C-reactive protein (P< 0.001), Serum amyloid A (P< 0.001), and Erythrocyte sedimentation rate (P< 0.001). Except for above indicators, Alkaline phosphatase (P= 0.009), Procalcitonin (P= 0.010), and D-dimer(P< 0.001) increased further during periods of symptoms compared with those levels in pre-symptomatic period.
Conclusion
In early stage after SARS-CoV-2 infection, images of chest CT and blood tests of asymptomatic patients were different from pre-symptomatic patients.
Article highlights
In asymptomatic patients with SARS-CoV-2 infection, the proportion of patients with normal chest CT was higher than that in pre-symptomatic patients.
In asymptomatic patients with SARS-CoV-2 infection, all those patients with unilateral pulmonary lesion sustained local damage during the whole course of disease.
In pre-symptomatic patients with SARS-CoV-2 infection, 70.6% of those with unilateral pulmonary lesion during pre-symptomatic period progressed to bilateral damage when symptoms appeared.
The levels of lymphocyte count, indicators of organ function tests and inflammatory factors were different between asymptomatic and pre-symptomatic patients with SARS-CoV-2 infection.
In pre-symptomatic patients with SARS-CoV-2 infection, the levels of lymphocyte count, indicators of organ function tests and inflammatory factors progressed further when symptoms appeared.
Authors’ contributions
All authors collected the clinical data. R. Yang, Y. Xiong, and S. Gao drafted the manuscript. X. Gui, Y. Xiong, and H. Ke supervised the final manuscript. All authors were responsible for summarizing all data related to this study.
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.