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Multicenter Study
. 2021 Aug;16(5):1173-1181.
doi: 10.1007/s11739-020-02561-3. Epub 2020 Nov 20.

Chest X-ray findings in a large cohort of 1117 patients with SARS-CoV-2 infection: a multicenter study during COVID-19 outbreak in Italy

Valentina Vespro  1 , Maria Carmela Andrisani  2 , Stefano Fusco  3 , Letizia Di Meglio  3 , Guido Plensich  3 , Alice Scarabelli  3 , Elvira Stellato  3 , Anna Maria Ierardi  2 , Luigia Scudeller  4 , Andrea Coppola  5 , Andrea Gori  6 , Antonio Pesenti  7 , Giacomo Grasselli  7 , Stefano Aliberti  8 , Francesco Blasi  8 , Chiara Villa  9 , Sonia Ippolito  9 , Barbara Pirrò  9 , Guglielmo Damiani  9 , Massimo Galli  10 , Giuliano Rizzardini  10 , Emanuele Catena  11 , Matteo Agostino Orlandi  12 , Sandro Magnani  12 , Giuseppe Cipolla  13 , Andrea Antonio Ianniello  14 , Mario Petrillo  14 , Genti Xhepa  14   15 , Antonio Scamporrino  15 , Alberto Cazzulani  15 , Gianpaolo Carrafiello  2   16
Affiliations
Multicenter Study

Chest X-ray findings in a large cohort of 1117 patients with SARS-CoV-2 infection: a multicenter study during COVID-19 outbreak in Italy

Valentina Vespro et al. Intern Emerg Med. 2021 Aug.

Abstract

To describe radiographic key patterns on Chest X-ray (CXR) in patients with SARS-CoV-2 infection, assessing the prevalence of radiographic signs of interstitial pneumonia. To evaluate pattern variation between a baseline and a follow-up CXR. 1117 patients tested positive for SARS-CoV-2 infection were retrospectively enrolled from four centers in Lombardy region. All patients underwent a CXR at presentation. Follow-up CXR was performed when clinically indicated. Two radiologists in each center reviewed images and classified them as suggestive or not for interstitial pneumonia, recording the presence of ground-glass opacity (GGO), reticular pattern or consolidation and their distribution. Pearson's χ2 test for categorical variables and McNemar test (χ2 for paired data) were performed. Patients mean age 63.3 years, 767 were males (65.5%). The main result is the large proportion of positive CXR in COVID-19 patients. Baseline CXR was positive in 940 patients (80.3%), with significant differences in age and sex distribution between patients with positive and negative CXR. 382 patients underwent a follow-up CXR. The most frequent pattern on baseline CXR was the GGO (66.1%), on follow-up was consolidation (53.4%). The most common distributions were peripheral and middle-lower lung zone. We described key-patterns and their distribution on CXR in a large cohort of COVID-19 patients: GGO was the most frequent finding on baseline CXR, while we found an increase in the proportion of lung consolidation on follow-up CXR. CXR proved to be a reliable tool in our cohort obtaining positive results in 80.3% of the baseline cases.

Keywords: COVID-19; Diagnosis; Pandemics; Radiography; Thoracic.

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Conflict of interest statement

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Figures

Fig. 1
Fig. 1
a CXR in antero-posterior view shows bilateral ground glass opacities (arrowheads) with peripheral distribution, involving middle-lower zone of the lungs. b Coronal reformatted CT image confirmed the CXR findings. c CXR in antero-posterior view shows bilateral reticular pattern with diffuse distribution on both axial and longitudinal plane. d Coronal reformatted CT image confirms the presence of diffuse interstitial involvement with reticular pattern
Fig. 2
Fig. 2
a CXR in postero-anterior view shows bilateral multifocal consolidation (arrowheads), with greater involvement of the right lung. Consolidation present peripheral predominant distribution. b CXR in antero-posterior view shows the presence of diffuse bilateral reticular pattern. Note the compresence of bilateral subtle GGO (arrowheads) with peripheral and middle-lower predominant distribution
Fig. 3
Fig. 3
Frequency of radiographic patterns on baseline and follow-up CXR (n = 382)
See this image and copyright information in PMC

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