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.
【저자키워드】 COVID-19, risk stratification, T cell exhaustion, asymptomatic patients, presymptomatic patients, 【초록키워드】 coronavirus disease, Coronavirus disease 2019, Hospitalized, Clinical symptoms, Prognosis, Clinical characteristics, Diagnosis, progression, Laboratory, China, outcomes, Asymptomatic, symptomatic, Wuhan, Patient, Clinical management, presymptomatic, characteristic, Admission, asymptomatic patients, differential diagnosis, single-cell, asymptomatic patient, COVID-19 patients, Analysis, COVID-19 patient, AUC, demographics, on admission, receiver operating characteristic, 95% CI, no significant difference, clinical symptom, help, receiver operating characteristic curve, single-center, Huoshenshan Hospital, IMPROVE, diagnosed, provided, case sery, correlated, stratified, CD8+T cell, patients with COVID-19, 【제목키워드】 Comparative, characterization,