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江苏省多中心研究:新型冠状病毒病 2019 无症状感染者的临床特征。

Clinical characteristics of asymptomatic carriers of novel coronavirus disease 2019: A multi-center study in Jiangsu Province.

机构信息

Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu Province, China.

Department of Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu Province, China.

出版信息

Virulence. 2020 Dec;11(1):1557-1568. doi: 10.1080/21505594.2020.1840122.

Abstract

Asymptomatic SARS-CoV-2-infected individuals are thought to play major roles in virus transmission. This study aimed to analyze the characteristics of asymptomatic carriers with COVID-19 to control the spread of the virus. We retrospectively investigated the clinical characteristics of 648 consecutive subjects who were enrolled in the study and were divided into asymptomatic carriers, mild cases, ordinary cases, severe or critical cases, and evaluated their impact on disease severity by means of Spearman correlation and multiple regression analyses. Receiver operating characteristic curve analysis was conducted to determine the optimum cutoff levels of laboratory findings for diagnostic predictors of asymptomatic carriers of COVID-19. In our study, a total of 648 subjects on admission with a mean age of 45.61 y including 345 males and 303 females were enrolled in our study. The leukocyte, lymphocyte, eosinophil, platelet, C-reactive protein, interleukin-6, CD3+, CD4+, and CD8 + T lymphocyte levels, and the erythrocyte sedimentation rate differed significantly among the groups (all ≤ 0.05). Disease severity was negatively associated with the CD3+ ( = -0.340; < 0.001), CD4+ ( = -0.290; = 0.001) and CD8+ ( = -0.322; < 0.001) T lymphocyte levels. The significant diagnostic predictors of asymptomatic carriers of COVID-19 included the blood cell, cytokine, and T lymphocyte subset levels. Inflammation and immune response may play important roles in disease progression. Hence, the laboratory parameters identified should be considered in clinical practice, which provide new insights into the identification of asymptomatic individuals and the prevention of virus transmission.

摘要

无症状 SARS-CoV-2 感染者被认为在病毒传播中发挥主要作用。本研究旨在分析 COVID-19 无症状感染者的特征,以控制病毒的传播。我们回顾性调查了 648 例连续入组的研究对象的临床特征,将其分为无症状携带者、轻症病例、普通病例、重症或危重症病例,并通过 Spearman 相关分析和多元回归分析评估其对疾病严重程度的影响。采用受试者工作特征曲线分析确定实验室检测结果的最佳截断值,以作为 COVID-19 无症状携带者的诊断预测因子。在本研究中,共纳入 648 例入院时平均年龄为 45.61 岁的患者,其中男性 345 例,女性 303 例。白细胞、淋巴细胞、嗜酸性粒细胞、血小板、C 反应蛋白、白细胞介素 6、CD3+、CD4+和 CD8+T 淋巴细胞水平以及红细胞沉降率在各组间差异有统计学意义(均 ≤0.05)。疾病严重程度与 CD3+( =-0.340; <0.001)、CD4+( =-0.290; =0.001)和 CD8+( =-0.322; <0.001)T 淋巴细胞水平呈负相关。COVID-19 无症状携带者的显著诊断预测因子包括血细胞、细胞因子和 T 淋巴细胞亚群水平。炎症和免疫反应可能在疾病进展中起重要作用。因此,应在临床实践中考虑确定的实验室参数,这为识别无症状个体和预防病毒传播提供了新的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74b1/7644248/455f2d3a5756/KVIR_A_1840122_F0001_OC.jpg

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