Chest Radiographic Findings in High-risk Covid-19 Pneumonia Patients
Abstract Background/ objectivesThe severity of Covid-19 pneumonia has shown a positive association with co-existing risk factors. However, the exact nature of lung involvement in high-risk Covid-19 patients is yet to be resolved. Therefore, we evaluated the CXR features, temporal progression, and the factors associated with CXR severity in high-risk patients.MethodsChest X-rays (n=289) of Covid-19 infected high-risk adults (n=228) treated at the Base Hospital Homagama were evaluated to record CXR features, their temporal progression, CXR severity score and the patient outcomes. ResultsThe studies patients (48.2% men) were in mean age(SD) of 59(15) years. The most frequent CXR features were patchy ground-glass opacities (49%; GG) and patchy consolidations (42%; CON). They showed bilateral (100%) involvement, superoinferior gradient (100%) and diffuse (27%), peripheral (18%) or perihilar (10%) distribution. CON was the predominant opacity among the non-survivors and GG among the survivors (χ2=14.73; p=0.001). Right lung predominant (28%) asymmetrical lung involvement was more frequent than bilateral symmetrical (16%) or left lung predominance (7%). Progression into fatal disease was significantly higher when the lung involvement is asymmetrical: right predominance: ODDs:0.502; p=0.023; left predominance: ODDs:0.268; p=0.002. The CXRs were frequently normal in early (66%) and progressive (56%; χ2=36.64; p<0.001) stages than in peak or resolving stages. The predictors of CXR severity included age (β:0.140; 95% CI:0.041–0.233; p=0.004), male gender (β:4.140; 95% CI:1.452–6.481; p=0.003), and disease day (β:0.622; 95% CI:0.301–0.942; p<0.001). ConclusionThis study decoded the CXR features of Covid-19 pneumonia in a high-risk cohort while describing their associations.