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. 2021 Jun;76(6):473.e1-473.e7.
doi: 10.1016/j.crad.2021.02.005. Epub 2021 Feb 18.

Initial chest radiograph scores inform COVID-19 status, intensive care unit admission and need for mechanical ventilation

B Shen  1 , M Hoshmand-Kochi  1 , A Abbasi  1 , S Glass  1 , Z Jiang  1 , A J Singer  2 , H C Thode  2 , H Li  1 , W Hou  1 , T Q Duong  3
Affiliations

Initial chest radiograph scores inform COVID-19 status, intensive care unit admission and need for mechanical ventilation

B Shen et al. Clin Radiol. 2021 Jun.

Abstract

Aim: To evaluate whether portable chest radiography (CXR) scores are associated with coronavirus disease 2019 (COVID-19) status and various clinical outcomes.

Materials and methods: This retrospective study included 500 initial CXR from COVID-19-suspected patients. Each CXR was scored based on geographic extent and degree of opacity as indicators of disease severity. COVID-19 status and clinical outcomes including intensive care unit (ICU) admission, mechanical ventilation, mortality, length of hospitalisation, and duration on ventilator were collected. Multivariable logistic regression analysis was performed to evaluate the relationship between CXR scores and COVID-19 status, CXR scores and clinical outcomes, adjusted for code status, age, gender and co-morbidities.

Results: The interclass correlation coefficients amongst raters were 0.94 and 0.90 for the extent score and opacity score, respectively. CXR scores were significantly (p < 0.01) associated with COVID-19 positivity (odd ratio [OR] = 1.49; 95% confidence interval [CI]: 1.27 - 1.75 for extent score and OR = 1.75; 95% CI: 1.42 - 2.15 for opacity score), ICU admission (OR = 1.19; 95% CI: 1.09 - 1.31 for extent score and OR = 1.26; 95% CI: 1.10 - 1.44 for opacity score), and invasive mechanical ventilation (OR = 1.22; 95% CI: 1.11 - 1.35 for geographic score and OR = 1.21; 95% CI: 1.05 - 1.38 for opacity score). CXR scores were not significantly different between survivors and non-survivors after adjusting for code status (p>0.05). CXR scores were not associated with length of hospitalisation or duration on ventilation (p>0.05).

Conclusions: Initial CXR scores have prognostic value and are associated with COVID-19 positivity, ICU admission, and mechanical ventilation.

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Figures

Figure 1
Figure 1
Flowchart describing patient selection, triage and outcome of the 500 persons under investigation.
Figure 2
Figure 2
Examples showing a range of CXR severity scores, which include extent and opacity scores. The two numbers for each are for the right and left lung. Arrows indicate region of ground glass opacities or/and airspace consolidations.
See this image and copyright information in PMC

References

    1. Li Q., Guan X., Wu P. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199–1207. - PMC - PubMed
    1. Hui D.S., E I.A., Madani T.A. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health — the latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020;91:264–266. - PMC - PubMed
    1. Wang W., Xu Y., Gao R. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. 2020;323(18):1843–1844. - PMC - PubMed
    1. Johns Hopkins University . Global Map; 2020. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University.https://coronavirus.jhu.edu/map.html Available at.
    1. Tang Y.W., Schmitz J.E., Persing D.H. Laboratory diagnosis of COVID-19: current issues and challenges. J Clin Microbiol. 2020;58(6) - PMC - PubMed