Chest X-ray findings in COVID-19 patients: a descriptive study
DOI:
https://doi.org/10.18203/2349-3933.ijam20211435Keywords:
COVID-19, CXR, Lungs, Co-morbidities, BSTIAbstract
Background: Early suspicion and diagnosis remains the cornerstone for the better outcome of patients and to decrease cross infection in cases of COVID-19 pneumonia. In a country like Nepal X-ray facilities are readily available radiological tool in most of the centers and can be important screening tool. There is a lack of studies detailing the chest XR (C-XR) findings in these patients when compared to that dedicated to the CT features. Study aims to describe the patterns of the lung opacities in CXR in these patients.
Methods: This is retrospective descriptive study conducted at NMCTH in COVID-19 patients from 12 September to 17 October 2020. Demographic characteristics, symptoms, co-morbidities and C-XR findings were studied. CXR findings were categorized according to BSTI classification.
Results: Among 111 COVID-19 RT-PCR positive cases admitted 102 (91.9%) belonged to age group 18-65 years, 89 (80.2%) were males. Cough and fever were the commonest symptoms present in 109 (98.2%) patients. Ischemic heart disease and hypertension in 32 (28.8%) patients were the commonest co morbidities. According to British society of thoracic imaging (BSTI) COVID-19 CXR classification, six patients (5.4%) had normal chest X-rays. Classic/probable COVID-19 picture was present in 79 (71.17%) patients while (7.2%) had intermediate for COVID-19 X-ray findings. Among 79 patients with classic/probable COVID-19 CXR findings 71 (89.8%) had bilateral consolidation/ground glass haze, 72 (91.1%) had peripheral lung involvement while 66 (83.5%) had middle and lower zone involvement.
Conclusions: Ground glass opacities/consolidations with bilateral location, peripheral distribution and middle- lower zone predominance were the commonest X-ray findings in our study.
References
World Health Organization. Naming the coronavirus disease (COVID-19) and the virus that causes it: World Health Organization (WHO). Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technicalguidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it. Accessed on 27th March 2021.
World Health Organization. 2019-nCoV outbreak is an emergency of international concern. 2020. Available at: http://www.euro.who.int/en/health-topics/emergencies/pages/news/news/2020/01/2019-ncov-outbreak-is-an-emergency-of- international-concern. Accessed on 27th March 2020.
Shrestha R, Shrestha S, Khanal P, KC B. Nepal’s first case of COVID-19 and public health response. J Travel Med. 2020;27(3):024.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
CDC, Centers for disease control and prevention. Groups at higher risk for severe illness. Available at: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Accessed on 27th March 2020.
Nepal concludes first phase of COVID-19 vaccination drive; 184,857 receive. Available at: https://the himalayantimes.com/nepal/nepal-concludes-first-phase-of-covid-19-vaccination-drive-184857-receive-jab. Accessed on 27th March 2020.
Hare S, Rodrigues J, Nair A. The continuing evolution of COVID-19 imaging pathways in the UK: a British Society of Thoracic Imaging expert reference group update. Clin Radiol. 2020;75:399-404.
NHS England Specialty guides for patient management during the coronavirus pandemic Clinical guide for the management of Radiology patients during the coronavirus pandemic. Available at: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/specialty-guide-radiology-and-coronavirus-v1-20-march-2020.pdf. Accessed on 27th March 2020.
Tavare AN, Braddy A, Brill S. Managing high clinical suspicion COVID-19 inpatients with negative RT-PCR: a pragmatic and limited role for thoracic CT Thorax. 2020.
Rodrigues JCL, Hare SS, Edey A, Devaraj A, Jacob J, Johnstone A et al. An update on COVID-19 for the radiologist - A British society of Thoracic Imaging statement. Clin Radiol. 2020;75(5):323-5.
Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J. Fleischner Society: Glossary of terms for thoracic imaging. Radiology. 2008;246(3):697-722.
Durrani M, Haq IU, Kalsoom U, Yousaf A. Chest X-rays findings in COVID 19 patients at a University Teaching Hospital - A descriptive study. Pak J Med Sci. 2020;36(COVID19-S4):S22-6.
Bajracharya S, Shrestha A, Rajbhandari B. Symptoms of COVID-19 Confirmed cases Presenting to Emergency Department in A Tertiary Care Centre: A Descriptive Cross-sectional Study. J Nepal Med Assoc. 2020;31
Richardson S, Hirsch JS, Narasimhan M. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323(20):2052-9.
Rousan LA, Elobeid E, Karrar M. Chest x-ray findings and temporal lung changes in patients with COVID-19 pneumonia. BMC Pulm Med. 2020;20:245.
Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for Radiologists on COVID-19: An Update-Radiology Scientific Expert Panel. Radiology. 2020;27.
Wong HYF, Lam HYS, Fong AH-T, Leung ST, Chin TW-Y, Lo CSY et al. Frequency and distribution of chest radiographic findings in COVID-19 positive patients. Radiology. 2020;27.
