Clinical progression and changes of chest CT findings among asymptomatic and pre-symptomatic patients with SARS-CoV-2 infection in Wuhan, China.

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 (< 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 (< 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(= 0.003). Compared with asymptomatic patients, pre-symptomatic COVID-19 patients had worse levels of Lymphocyte count (= 0.001), Albumin (= 0.045), Aspartate aminotransferase (= 0.044), γ-glutamyl transpeptadase (= 0.016), Globulin (= 0.036), Creatinine (= 0.021), Lactate dehydrogenase (= 0.008), C-reactive protein (< 0.001), Serum amyloid A (< 0.001), and Erythrocyte sedimentation rate (< 0.001). Except for above indicators, Alkaline phosphatase (= 0.009), Procalcitonin (= 0.010), and D-dimer(< 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.