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Expert Rev Respir Med . Clinical progression and changes of chest CT findings among asymptomatic and pre-symptomatic patients with SARS-CoV-2 infect

tetano

Editor, Senior Moderator
Expert Rev Respir Med


. 2020 Nov 2;1-7.
doi: 10.1080/17476348.2021.1840358. Online ahead of print.
Clinical progression and changes of chest CT findings among asymptomatic and pre-symptomatic patients with SARS-CoV-2 infection in Wuhan, China


Rongrong Yang[SUP] 1 [/SUP], Xien Gui[SUP] 1 [/SUP], Shicheng Gao[SUP] 1 [/SUP], Hengning Ke[SUP] 1 [/SUP], Yong Xiong[SUP] 1 [/SUP]



Affiliations

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.

Keywords: Coronavirus disease 2019; D-dimer; aspartate aminotransferase; asymptomatic patients; presymptomatic patients; severe acute respiratory syndrome coronavirus-2.
 
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