Subscribe to RSS
Download PDF
DOI: 10.4103/ijri.IJRI_480_20
Role of portable chest radiography in management of COVID-19: Experience of 422 patients from a tertiary care center in India
Financial support and sponsorship Nil.
Abstract
Objective: To analyze radiological changes in portable chest radiographs in coronavirus disease-19(COVID-19) patients to optimize the management of hospitalized patients. Methods: We retrospectively reviewed 638 portable radiographs of 422 hospitalized COVID-19 patients with RT-PCR confirmed COVID-19 infection. All the radiographs were reported in a structured format by two experienced radiologists. A severity score was assigned to every Chest Xray (CXR) and correlation was done with the CT scans whenever available. Results: Out of 422 baseline portable radiographs assessed,the ratio of male: female patients was 337:85 that is 79.8% were males and 20.14% were females.The mean age was 50.5 years and the range was 17–84 years.Of these 422 patients, 187 patients (44.3%) had abnormal baseline CXR. 161 out of 187 (86%) had either typical or indeterminate findings for COVID-19 pneumonia, rest 26 (13.9%) patients had CXR findings not consistent with COVID-19, like pleural effusion, hydropneumothorax, or lung cavity.Most commonly observed CXR findings in COVID 19 pneumonia were bilateral, multifocal air space opacities (consolidation and ground-glass opacities) predominantly involving lower zones and peripheral lung fields. X-ray identifiable lung changes of COVID-19 were mostly seen at 9-11 days after symptom onset. Conclusion: The presence of multifocal air-space opacities with bilateral, peripheral distribution on chest radiograph is highly suggestive of COVID-19 pneumonia in this pandemic setting.Portable chest radiography is a widely available and quicktool for estimating the evolution and assessing the severity of lung involvement of COVID-19 pneumonia in hospitalized symptomatic patients.
Keywords
CT-computed tomography - CXR-chest radiography - GGO-ground glass opacity - RT-PCR – reverse transcriptase polymerase chain reactionPublication History
Received: 12 June 2020
Accepted: 08 September 2020
Article published online:
13 July 2021
© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX. et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-20
- 2 Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506
- 3 Basha MM, Meltzer CC, Kim DC, Tuite MJ, Kolli KP, Tan BS. Radiology department preparedness for Covid-19: Radiology scientific expert panel. Radiology 2020; 295: E8
- 4 Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestation of new Coronavirus disease 2019 (COVID-19): A pictorial review. Eur Radiol 2020; 30: 4381-9
- 5 Kim H. Outbreak of novel coronavirus (COVID-19): What is the role of radiologists?. Eur Radiol 2020; 30: 3266-7
- 6 Jacobi A, Chung M, Bernheim A, Eber C. Portable chest X-ray in coronavirus disease-19 (COVID-19): A pictorial review. Clin Imaging 2020; 64: 35-42
- 7 Wong HYF, Lam HYS, Fong AH, Leung ST, Chin TW, Lo CSY. et al. Frequency and distribution of chest radiographic findings in patients positive forCOVID-19. Radiology 2020; 296: E72-8
- 8 Orsi MA, Oliva AG, Cellina M. Radiology department preparedness for COVID-19: Facing an unexpected outbreak of the disease. Radiology 2020; 295: E8
- 9 Warren MA, Zhao Z, Koyama T, Bastarache JA, Shaver CM, Semler MW. Severity score of lung odema on the chest radiograph is asscociated with clinical outcomes in ARDS. Thora× 2018; 73: 840-6
- 10 Thoracic Imagingin. COVID-19Infection.Guidance for the Reporting Radiologist. British Society of Thoracic Imaging. Version 2. 16th March 2020.
- 11 Yoon SH, Lee KH, Kim JY, Lee YK, Ko H, Kim KH. et al. Chest radiographic and CT findings of the 2019 novel coronavirus disease: Analysis of nine patients treated in Korea. Korean J Radiol 2020; 21: 494-500
- 12 Ng MY, Lee E, Yang J, Yang F, Li X, Wang H. et al. Imaging profile of the COVID-19 infection: Radiologicfindings and literature review. Radiol Cardiothorac Imaging 2020; 2: e200034
- 13 Pan F, Ye T, Sun P, Gui S, Liang B, Li L. et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus peumonia. Radiology 2020; 295: 715-21
- 14 Hosseiny M, Kooraki S, Gholamrezanezhad A, Reddy S, Myer L. Radiology perspective of coronavirus disease 2019(COVID-19): Lessons from severeacute respiratory syndrome and Middle East respiratory syndrome. Cardiopulmonary Imaging 2020; 214: 1078-82
- 15 Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): Asystematic review of imaging findings in 919 patients. AJR Am J Roentgen 2020; 14: 87-93
- 16 Vilar J, Domingo ML, Soto C, Cogollos J. Radiology of bacterial pneumonia. J Eur J Radiol 2004; 51: 102-13
- 17 Rubin GD, Ryerson CJ, Haramati LB, Sverzellati N, Kanne JP, Raoof S. et al. The role of chest imaging in patient management during the COVID-19 pandemic: A multinational consensus statement from the Fleischner Society. Radiology 2020; 296: 172-80