Role of Chest X-ray abnormalities in predicting outcome of COVID-19 in Young Adult Patient

Author(s):  
Rawnak Jahan ◽  
Mohammed Atiqur Rahman ◽  
AKM Mosharraf Hossain ◽  
Shamim Ahmed ◽  
Rajashish Chakrabortty ◽  
...  

COVID-19 is a highly infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Recently COVID -19 radiological literature focuses primarily on CT scan findings which are more sensitive (about 97%) and specific than chest x-ray. But it has to be remembered that performing CT scan is not easy during this pandemic situation. So, the aim of the study was to analyze the chest x-ray severity scoring system and its association with outcome in a young adult patient with COVID-19. This cross-sectional study was carried out from September 15 to December 31 2020 in the COVID unit of BSMMU and it included 100 RT-PCR positive COVID-19 patients according to selection criteria. Chest x-ray postero-anterior view was done in the radiology department of BSMMU. Each patient’s chest x-ray was examined by a radiologist and a pulmonologist with experience of 10 years. Radiological scoring was done by using a scoring system. All patients were followed after 20 days from the first presentation to see the outcome. Out of 100 patients, 73 patients (73%) needed hospital admission, 33(33%) patients were hospitalized but did not developed sepsis, 29 (29%) patient developed sepsis, 10(10%) patient needed ICU support among them 2 patients got intubation. 1(1%) patient was dead. Radiological score ≥ 4 was associated with increased risk of hospitalization. (Area under curve = 0.956). Score ≥ 5 was associated with increased risk of sepsis; score ≥7 was associated with increased risk of ICU admission. (p-value<0.001). BSMMU J 2021; 14 (COVID -19 Supplement): 30-35

Author(s):  
Nishant Agrawal ◽  
Samruddhi Dhanaji Chougale ◽  
Prashant Jedge ◽  
Shivakumar Iyer ◽  
John Dsouza

Introduction: In early stage of disease of Coronavirus Disease 2019 (COVID-19) infection chest Computed Tomography (CT) imaging is considered as the most effective method for detecting lung abnormalities. A Brixia Chest X-ray (CXR) scoring system which uses an 18-point severity scale to grade lung abnormalities due to COVID-19 was developed to improve the risk stratification for infected patients. Aim: To ascertain the validity of Brixia scoring system and to measure the outcome in COVID-19 patients. Materials and Methods: A retrospective study was conducted from 1st April 2020 to 31st July 2020, at a tertiary care hospital in India. Baseline CXR of COVID-19 patients were scored based on Brixia scoring system. The lungs were divided into six equal zones. Subsequently, scores (from 0-3) were assigned to each zone, based on lung abnormalities. A group comparison was implemented using Chi-Square test for categorical variables. Whereas an independent t-test was applied for continuous variables that followed normal distribution. Results: The study included 130 patients. The mean age was 57.09±13.73 years, 70.8% patients included were males. Out of 130 patients, 79 patients died. Among patients who died the mean CXR score was calculated to be 12.13±2.50. The mean CXR score was calculated to be 11.18±2.30 in patients who recovered and got discharged. During the process of comparison of CXR scores with the outcomes, the t-value came out to be 2.20 and the resulting p-value was 0.03 (statistically significant). Conclusion: Brixia score more than 12 was associated with increased mortality due to COVID-19, with p-value of 0.03.


2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Sohail Ahmed Khan ◽  
Murli Manohar ◽  
Maria Khan ◽  
Samita Asad ◽  
Syed Omair Adil

Background & Objective: Radiology has played a significant role in the diagnosis and quantifying the severity of COVID 19 pulmonary disease. This study was conducted to assess patterns and severity of COVID-19 pulmonary disease based on radiological imaging. Methods: A prospective observational study was conducted in a large tertiary care public sector teaching hospital of Karachi, Pakistan from June 2020 till August 2020. All confirmed and suspected COVID-19 patients referred for chest X-rays and computed tomography (CT) scans were evaluated along with RT-PCR results. Suspected patients were followed for RT-PCR. Radiological features and severity of imaging studies were determined. Results: Of 533 patients in whom X-rays were performed, majority had severe/critical findings, i.e., 304 (57.03%). Of 97 patients in whom CT scan was performed, mild/moderate findings were observed in 63 (64.94%) patients. Of 472 patients with abnormal X-rays, majority presented with alveolar pattern 459 (97.2%), bilateral lung involvement 453 (89.6%), and consolidation 356 (75.4%). Moreover, lobar predominance showed lower zone preponderance in 446 (94.5%) patients. Of 88 patients with abnormal CT findings, ground-glass opacity (GGO) 87 (98.9%) and crazy paving 69 (78.4%) were the most common findings. An insignificantly higher association of PCR positive cases was observed with severe/critical X-rays (p-value 0.076) and CT scan findings (p-value 0.431). Conclusion: Most common patterns on CT scans were GGO and crazy paving. While on chest radiographs, bilateral lung involvement with alveolar pattern and consolidation were most common findings. On X-rays, majority had severe/critical whereas CT scan had mild/moderate findings. doi: https://doi.org/10.12669/pjms.37.5.4290 How to cite this:Khan SA, Manohar M, Khan M, Asad S, Adil SO. Radiological profile of patients undergoing Chest X-ray and computed tomography scans during COVID-19 outbreak. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4290 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Author(s):  
Akın Çinkooğlu ◽  
Selen Bayraktaroğlu ◽  
Naim Ceylan ◽  
Recep Savaş

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.


Author(s):  
Vinayakumar Ravi ◽  
Harini Narasimhan ◽  
Chinmay Chakraborty ◽  
Tuan D. Pham
Keyword(s):  
Ct Scan ◽  
X Ray ◽  

2001 ◽  
Vol 90 (6) ◽  
pp. 1070-1072
Author(s):  
Emi Tajima ◽  
Hidetsugu Mihara ◽  
Motohiro Wakabayashi ◽  
Masaya Watarai ◽  
Kazutaka Sugamura ◽  
...  

Author(s):  
R. Behzadmehr ◽  
E. Nejadkehkha

Despite many advances in the diagnosis, screening, and rapid treatment of tuberculosis, it is still a public health concern in the world. Due to the importance of this issue in diagnosis and reduction of transmission of infection and treatment of the disease especially where this study is conducted due to the high prevalence of tuberculosis, this study was done to determine The relationship between sputum smear positivity grade and chest X-ray findings in pulmonary tuberculosis patients in a hospital in southeast of Iran. This cross-sectional study was performed on all patients with pulmonary TB referencing the health centers in Zabol city, southeast of Iran from 1 January 2015 to 30 December 2020. Sputum smear and radiographic findings of the chest X-ray were evaluated. Data was collected using a form of information and finally analyzed by SPSS 22. Out of 101 patients examined in the present study, 71 were women and 30 were men. The mean age of the patients was 62.68 ± 13.61 years. The frequency of opacity in patients with grades 1, 2, and 3 was 71.4, 78.5, and 76.5%, respectively. Frequency of cavitation in patients with Grade 1, 2 and 3 was 11.5%, 28.5% and 52.9% respectively (P value 0.001). The frequency of reticulonodular presentations in patients with grade 1, 2, and 3 was 24.2, 7.1, and 0%, respectively.  In general, the results of this study showed that, with increasing grading of smears (1+, 2+, and 3+), the frequency of cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. In general, the results of this study showed that, with increasing grading of smears (, the frequency of Cavitation presentation increased significantly and the frequency of reticulonodular presentations decreased significantly. The findings of the present study can help physicians better diagnose TB.


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