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Neutrophils and Lymphocytes Can Help Distinguish Asymptomatic COVID-19 From Moderate COVID-19
Xuefeng Gu1,2, Ling Sha3, Shaofeng Zhang2
1Medical School, Southeast University, Nanjing, China.
Insights
A new diagnostic model can differentiate asymptomatic coronavirus disease 2019 (COVID-19) from moderate COVID-19. This model uses neutrophil and lymphocyte counts to identify patients with potential asymptomatic COVID-19, aiding clinical decision-making.
Area of Science:
- Medical diagnostics
- Infectious disease epidemiology
- Clinical immunology
Background:
- Asymptomatic and moderate coronavirus disease 2019 (COVID-19) represent common disease presentations.
- Distinguishing between asymptomatic and symptomatic COVID-19 is crucial for patient management and public health.
- Developing accurate diagnostic tools for these patient groups is essential.
Purpose of the Study:
- To develop a diagnostic model for differentiating asymptomatic COVID-19 from moderate COVID-19.
- To identify demographic, clinical, and laboratory variables that predict COVID-19 symptom presence.
- To establish a reliable method for identifying patients with asymptomatic COVID-19.
Main Methods:
- A retrospective study comparing 15 asymptomatic COVID-19 patients with 57 moderate COVID-19 patients.
- Collection and analysis of demographic, clinical, routine blood tests, and other laboratory data.
- Multivariate analysis to identify independent predictors of clinical symptoms.
Main Results:
- Asymptomatic COVID-19 patients were younger, with higher CD8+ T cell, C-reactive protein, white blood cell, neutrophil, lymphocyte, and eosinophil counts, and higher serum iron levels.
- Neutrophil (NEU) and lymphocyte (LYM) counts were identified as independent predictors of clinical symptoms.
- The developed diagnostic model demonstrated high discriminatory power and consistency.
Conclusions:
- A diagnostic model utilizing neutrophil and lymphocyte counts can effectively distinguish asymptomatic COVID-19 from moderate COVID-19.
- This model assists clinicians in identifying patients with potential asymptomatic COVID-19.
- The findings support the use of specific laboratory markers for improved COVID-19 patient stratification.
Introduction:
Asymptomatic coronavirus disease 2019 (COVID-19) and moderate COVID-19 may be the most common COVID-19 cases. This study was designed to develop a diagnostic model for patients with asymptomatic and moderate COVID-19 based on demographic, clinical, and laboratory variables.
Methods:
This retrospective study divided the subjects into 2 groups: asymptomatic COVID-19 (without symptoms, n = 15) and moderate COVID-19 (with symptoms, n = 57). Demographic characteristics, clinical data, routine blood tests, other laboratory tests, and inpatient data were collected and analyzed to compare patients with asymptomatic COVID-19 and moderate COVID-19.
Results:
Comparison of the asymptomatic COVID-19 group with the moderate COVID-19 group yielded the following results: the patients were younger (P = 0.045); the cluster of differentiation (CD)8+ (cytotoxic) T cell level was higher (P = 0.017); the C-reactive protein (CRP) level was lower (P = 0.001); the white blood cell (WBC, P < 0.001), neutrophil (NEU, P = 0.036), lymphocyte (LYM, P = 0.009), and eosinophil (EOS, P = 0.036) counts were higher; and the serum iron level (P = 0.049) was higher in the asymptomatic COVID-19 group. The multivariate analysis showed that the NEU count (odds ratio [OR] = 2.007, 95% confidence interval (CI): 1.162 - 3.715, P = 0.014) and LYM count (OR = 9.380, 95% CI: 2.382 - 36.934, P = 0.001) were independent factors for the presence of clinical symptoms after COVID-19 infection. The NEU count and LYM count were diagnostic predictors of asymptomatic COVID-19. This diagnostic prediction model showed high discriminatory power, consistency, and net clinical benefits.
Conclusions:
The proposed model can distinguish asymptomatic COVID-19 from moderate COVID-19, thereby helping clinicians identify and distinguish patients with potential asymptomatic COVID-19 from those with moderate COVID-19.
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