Frontiers in Immunology (Jul 2021)
Comparative Characterization and Risk Stratification of Asymptomatic and Presymptomatic Patients With COVID-19
- Lei Shi,
- Rong Ding,
- Rong Ding,
- Tingting Zhang,
- Tingting Zhang,
- Wei Wu,
- Wei Wu,
- Wei Wu,
- Ziyu Wang,
- Ziyu Wang,
- Xiuzhi Jia,
- Kening Li,
- Kening Li,
- Yuan Liang,
- Yuan Liang,
- Jie Li,
- Jie Li,
- Mengyan Zhu,
- Mengyan Zhu,
- Bin Huang,
- Bin Huang,
- Lingxiang Wu,
- Lingxiang Wu,
- Min Wu,
- Min Wu,
- Jing Chen,
- Jing Chen,
- Chaochen Wang,
- Chaochen Wang,
- Bin Huang,
- Caidong Liu,
- Hongbing Shen,
- Hongbing Shen,
- Qianghu Wang,
- Qianghu Wang,
- Qianghu Wang,
- Qianghu Wang,
- Qianghu Wang,
- Xinyi Xia,
- Xinyi Xia,
- Pengping Li,
- Pengping Li,
- Sali Lyu,
- Sali Lyu,
- Ying Xiao
Affiliations
- Lei Shi
- Affiliated First People’s Hospital of Kunshan, Gusu College of Nanjing Medical University, Suzhou, China
- Rong Ding
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Rong Ding
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Tingting Zhang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Tingting Zhang
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Wei Wu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Wei Wu
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Wei Wu
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
- Ziyu Wang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Ziyu Wang
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Xiuzhi Jia
- Central Lab of Biomedical Research Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Kening Li
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Kening Li
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Yuan Liang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Yuan Liang
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Jie Li
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jie Li
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Mengyan Zhu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Mengyan Zhu
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Bin Huang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Bin Huang
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Lingxiang Wu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Lingxiang Wu
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Min Wu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Min Wu
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Jing Chen
- Department of Breast Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
- Jing Chen
- ZJU-UoE Institute, Zhejiang University School of Medicine, Zhejiang University, Haining, China
- Chaochen Wang
- Department of Breast Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
- Chaochen Wang
- ZJU-UoE Institute, Zhejiang University School of Medicine, Zhejiang University, Haining, China
- Bin Huang
- The Comprehensive Cancer Center of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School & Clinical Cancer Institute of Nanjing University, Nanjing, China
- Caidong Liu
- Department of Laboratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- Hongbing Shen
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Hongbing Shen
- 0Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, Nanjing, China
- Qianghu Wang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Qianghu Wang
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Qianghu Wang
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
- Qianghu Wang
- 0Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, Nanjing, China
- Qianghu Wang
- 1Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing, China
- Xinyi Xia
- 2COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, China
- Xinyi Xia
- 3Joint Expert Group for COVID-19, Department of Laboratory Medicine & Blood Transfusion, Wuhan Huoshenshan Hospital, Wuhan, China
- Pengping Li
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Pengping Li
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Sali Lyu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Sali Lyu
- Department of Bioinformatics, Nanjing Medical University, Nanjing, China
- Ying Xiao
- Central Lab of Biomedical Research Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- DOI
- https://doi.org/10.3389/fimmu.2021.700449
- Journal volume & issue
-
Vol. 12
Abstract
The identification of asymptomatic, non-severe presymptomatic, and severe presymptomatic coronavirus disease 2019 (COVID-19) in patients may help optimize risk-stratified clinical management and improve prognosis. This single-center case series from Wuhan Huoshenshan Hospital, China, included 2,980 patients with COVID-19 who were hospitalized between February 4, 2020 and April 10, 2020. Patients were diagnosed as asymptomatic (n = 39), presymptomatic (n = 34), and symptomatic (n = 2,907) upon admission. This study provided an overview of asymptomatic, presymptomatic, and symptomatic COVID-19 patients, including detection, demographics, clinical characteristics, and outcomes. Upon admission, there was no significant difference in clinical symptoms and CT image between asymptomatic and presymptomatic patients for diagnosis reference. The mean area under the receiver operating characteristic curve (AUC) of the differential diagnosis model to discriminate presymptomatic patients from asymptomatic patients was 0.89 (95% CI, 0.81-0.98). Importantly, the severe and non-severe presymptomatic patients can be further stratified (AUC = 0.82). In conclusion, the two-step risk-stratification model based on 10 laboratory indicators can distinguish among asymptomatic, severe presymptomatic, and non-severe presymptomatic COVID-19 patients on admission. Moreover, single-cell data analyses revealed that the CD8+T cell exhaustion correlated to the progression of COVID-19.
Keywords
