TY - JOUR
T1 - Feasibility, reproducibility, and clinical validity of a quantitative chest X-ray assessment for COVID-19
AU - Orsi, Marcello A.
AU - Oliva, Giancarlo
AU - Toluian, Tahereh
AU - Pittino, Carlo Valenti
AU - Panzeri, Marta
AU - Cellina, Michaela
N1 - Publisher Copyright:
Copyright © 2020 by The American Society of Tropical Medicine and Hygiene
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/8
Y1 - 2020/8
N2 - Chest X-ray (CXR) is an essential first-line tool in COVID-19 pneumonia diagnosis and management. Our study aimed at assessing 1) CXR manifestations, frequency, and distribution; 2) the feasibility and repeatability of a CXR severity score; and 3) the correlation between the CXR severity score and clinical and laboratory parameters. We reviewed baseline CXRs and clinical data of consecutive patients who presented to our emergency department and resulted positive at SARS-CoV-2 reverse transcriptase-PCR oropharyngeal swab test from March 1, 2020 to April 6, 2020. Lung abnormalities and their distribution were analyzed. A score of CXR severity was assigned by two radiologists, independently, according to the extent of lung involvement, with a maximum score of 8 for CXR. Correlations between the CXR score and the clinical data were assessed. One hundred fifty-five patients were included; 143/155 (92%) were positive at baseline CXR. Ground-glass opacity was the most common finding (141/143, 99%). Involvement was mainly bilateral (96/143, 67%), with peripheral distribution (79/143, 55%). The mean CXR severity score was 3.3 (±2); interobserver agreement was excellent, with a Cohen's K correlation coefficient of 0.901. The CXR score showed a significant positive correlation with C-reactive protein, lactate dehydrogenase, and fever duration, and a negative correlation with oxygen saturation. Chest X-ray findings are in line with those reported by computed tomography studies. The use of a visual CXR score, easy to assess and highly reproducible, can reflect the clinical severity and help the patients' management.
AB - Chest X-ray (CXR) is an essential first-line tool in COVID-19 pneumonia diagnosis and management. Our study aimed at assessing 1) CXR manifestations, frequency, and distribution; 2) the feasibility and repeatability of a CXR severity score; and 3) the correlation between the CXR severity score and clinical and laboratory parameters. We reviewed baseline CXRs and clinical data of consecutive patients who presented to our emergency department and resulted positive at SARS-CoV-2 reverse transcriptase-PCR oropharyngeal swab test from March 1, 2020 to April 6, 2020. Lung abnormalities and their distribution were analyzed. A score of CXR severity was assigned by two radiologists, independently, according to the extent of lung involvement, with a maximum score of 8 for CXR. Correlations between the CXR score and the clinical data were assessed. One hundred fifty-five patients were included; 143/155 (92%) were positive at baseline CXR. Ground-glass opacity was the most common finding (141/143, 99%). Involvement was mainly bilateral (96/143, 67%), with peripheral distribution (79/143, 55%). The mean CXR severity score was 3.3 (±2); interobserver agreement was excellent, with a Cohen's K correlation coefficient of 0.901. The CXR score showed a significant positive correlation with C-reactive protein, lactate dehydrogenase, and fever duration, and a negative correlation with oxygen saturation. Chest X-ray findings are in line with those reported by computed tomography studies. The use of a visual CXR score, easy to assess and highly reproducible, can reflect the clinical severity and help the patients' management.
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U2 - 10.4269/ajtmh.20-0535
DO - 10.4269/ajtmh.20-0535
M3 - Article
C2 - 32618262
AN - SCOPUS:85089204262
VL - 103
SP - 822
EP - 827
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
SN - 0002-9637
IS - 2
ER -