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Comparative Characterization and Risk Stratification of Asymptomatic and Presymptomatic Patients With COVID-19

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...

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Autores principales: Shi, Lei, Ding, Rong, Zhang, Tingting, Wu, Wei, Wang, Ziyu, Jia, Xiuzhi, Li, Kening, Liang, Yuan, Li, Jie, Zhu, Mengyan, Huang, Bin, Wu, Lingxiang, Wu, Min, Chen, Jing, Wang, Chaochen, Liu, Caidong, Shen, Hongbing, Wang, Qianghu, Xia, Xinyi, Li, Pengping, Lyu, Sali, Xiao, Ying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301218/
https://www.ncbi.nlm.nih.gov/pubmed/34305939
http://dx.doi.org/10.3389/fimmu.2021.700449
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author Shi, Lei
Ding, Rong
Zhang, Tingting
Wu, Wei
Wang, Ziyu
Jia, Xiuzhi
Li, Kening
Liang, Yuan
Li, Jie
Zhu, Mengyan
Huang, Bin
Wu, Lingxiang
Wu, Min
Chen, Jing
Wang, Chaochen
Huang, Bin
Liu, Caidong
Shen, Hongbing
Wang, Qianghu
Xia, Xinyi
Li, Pengping
Lyu, Sali
Xiao, Ying
author_facet Shi, Lei
Ding, Rong
Zhang, Tingting
Wu, Wei
Wang, Ziyu
Jia, Xiuzhi
Li, Kening
Liang, Yuan
Li, Jie
Zhu, Mengyan
Huang, Bin
Wu, Lingxiang
Wu, Min
Chen, Jing
Wang, Chaochen
Huang, Bin
Liu, Caidong
Shen, Hongbing
Wang, Qianghu
Xia, Xinyi
Li, Pengping
Lyu, Sali
Xiao, Ying
author_sort Shi, Lei
collection PubMed
description 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.
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spelling pubmed-83012182021-07-24 Comparative Characterization and Risk Stratification of Asymptomatic and Presymptomatic Patients With COVID-19 Shi, Lei Ding, Rong Zhang, Tingting Wu, Wei Wang, Ziyu Jia, Xiuzhi Li, Kening Liang, Yuan Li, Jie Zhu, Mengyan Huang, Bin Wu, Lingxiang Wu, Min Chen, Jing Wang, Chaochen Huang, Bin Liu, Caidong Shen, Hongbing Wang, Qianghu Xia, Xinyi Li, Pengping Lyu, Sali Xiao, Ying Front Immunol Immunology 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. Frontiers Media S.A. 2021-07-09 /pmc/articles/PMC8301218/ /pubmed/34305939 http://dx.doi.org/10.3389/fimmu.2021.700449 Text en Copyright © 2021 Shi, Ding, Zhang, Wu, Wang, Jia, Li, Liang, Li, Zhu, Huang, Wu, Wu, Chen, Wang, Huang, Liu, Shen, Wang, Xia, Li, Lyu and Xiao https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Shi, Lei
Ding, Rong
Zhang, Tingting
Wu, Wei
Wang, Ziyu
Jia, Xiuzhi
Li, Kening
Liang, Yuan
Li, Jie
Zhu, Mengyan
Huang, Bin
Wu, Lingxiang
Wu, Min
Chen, Jing
Wang, Chaochen
Huang, Bin
Liu, Caidong
Shen, Hongbing
Wang, Qianghu
Xia, Xinyi
Li, Pengping
Lyu, Sali
Xiao, Ying
Comparative Characterization and Risk Stratification of Asymptomatic and Presymptomatic Patients With COVID-19
title Comparative Characterization and Risk Stratification of Asymptomatic and Presymptomatic Patients With COVID-19
title_full Comparative Characterization and Risk Stratification of Asymptomatic and Presymptomatic Patients With COVID-19
title_fullStr Comparative Characterization and Risk Stratification of Asymptomatic and Presymptomatic Patients With COVID-19
title_full_unstemmed Comparative Characterization and Risk Stratification of Asymptomatic and Presymptomatic Patients With COVID-19
title_short Comparative Characterization and Risk Stratification of Asymptomatic and Presymptomatic Patients With COVID-19
title_sort comparative characterization and risk stratification of asymptomatic and presymptomatic patients with covid-19
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301218/
https://www.ncbi.nlm.nih.gov/pubmed/34305939
http://dx.doi.org/10.3389/fimmu.2021.700449
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