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, Maria Carmela Andrisani, Stefano Fusco, Letizia Di Meglio, Guido Plensich, Alice Scarabelli, Elvira Stellato, Anna Maria Ierardi, Luigia Scudeller, Andrea Coppola, Andrea Gori, Antonio Pesenti, Giacomo Grasselli, Stefano Aliberti, Francesco Blasi, Chiara Villa, Sonia Ippolito, Barbara Pirrò, Guglielmo Damiani, Massimo GalliGiuliano Rizzardini, Emanuele Catena, Matteo Agostino Orlandi, Sandro Magnani, Giuseppe Cipolla, Andrea Antonio Ianniello, Mario Petrillo, Genti Xhepa, Antonio Scamporrino, Alberto Cazzulani, Gianpaolo Carrafiello

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)1173-1181
Number of pages9
JournalInternal and Emergency Medicine
Issue number5
Publication statusPublished - Aug 2021


  • COVID-19
  • Diagnosis
  • Pandemics
  • Radiography
  • Thoracic

ASJC Scopus subject areas

  • Internal Medicine
  • Emergency Medicine


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