Emergency Department Chest X-ray Severity in Patients with COVID-19 Is Associated with Hypoxemia and Clinical Outcomes

Kotok, Daniel; Girard, C.; Robles, Jose Rivera; Kim, A.; Shettigar, Shruti; Lavina, A.; Gillenwater, S.; Hadeh, Anas

doi:10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2486

Cited by 2 publications

(1 citation statement)

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“…37 Kotok et al also reported that the group of patients with RALE scores with a median of 3 had more hospital admissions compared to those with a median of 2, and those with RALE scores with a median of 7 were more at risk for ICU admission. 38 However, some studies stated that there was no significant relationship between outcomes and chest X-rays because it relied on comorbidities. 39…”

Section: Discussionmentioning

confidence: 99%

The Correlations Between Clinical Characteristics and Inflammation Markers with Chest X-rays in COVID-19 Patients at Ulin Hospital

Nor,

Nurrasyidah,

Mashuri

2023

J Respirol Indones

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Background: Chest x-ray is one of the parameters used to estimate the severity and prognosis of COVID-19. Arterial oxygen saturation (SaO2), partial pressure of arterial oxygen (PaO2), and respiratory index (PaO/FiO2) can also predict the disease severity. Other parameters, like inflammation markers, have also been used as predictors for prognosis. Based on those considerations, this study aimed to examine their connection and find their correlation.Methods: This was an analytic observational retrospective study. The samples were moderate-critical COVID-19 patients in Ulin General Hospital Banjarmasin from July to December 2021 who met the inclusion and exclusion criteria. Statistical tests were used to see the relationship between clinical characteristics and inflammation markers with chest X-rays using various scoring systems (Brixia, sRALE, and modified Soetomo score).Results: The total number of subjects was 67. The data analysis found that the severity of the disease had a significant relationship with the severity of the chest x-ray (P<0.001). The PF ratio also had a significant negative correlation (P<0.001) with the severity of the chest x-ray. For inflammation markers, NLR, CRP, and LDH significantly correlated with a chest x-ray. The patient's outcome was also associated with a chest X-ray (P<0.015).Conclusion: There were significant correlations between clinical characteristics and inflammation markers on the chest X-ray severity, and sRALE was a better scoring system to assess chest X-ray severity than other scoring systems.

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Section: Discussionmentioning

confidence: 99%

The Correlations Between Clinical Characteristics and Inflammation Markers with Chest X-rays in COVID-19 Patients at Ulin Hospital

Nor,

Nurrasyidah,

Mashuri

2023

J Respirol Indones

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Radiographic Assessment of Lung Edema (RALE) Scores are Highly Reproducible and Prognostic of Clinical Outcomes for Inpatients with COVID-19

Al-Yousif¹,

Komanduri²,

Qurashi³

et al. 2022

Preprint

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INTRODUCTION: Chest imaging is necessary for diagnosis of COVID-19 pneumonia, but current risk stratification tools do not consider radiographic severity. We quantified radiographic heterogeneity among inpatients with COVID-19 with the Radiographic Assessment of Lung Edema (RALE) score on Chest X-rays (CXRs). METHODS: We performed independent RALE scoring by ≥2 reviewers on baseline CXRs from 425 inpatients with COVID-19 (discovery dataset), we recorded clinical variables and outcomes, and measured plasma host-response biomarkers and SARS-CoV-2 RNA load from subjects with available biospecimens. RESULTS: We found excellent inter-rater agreement for RALE scores (intraclass correlation co-efficient=0.93). The required level of respiratory support at the time of baseline CXRs (supplemental oxygen or non-invasive ventilation [n=178]; invasive-mechanical ventilation [n=234], extracorporeal membrane oxygenation [n=13]) was significantly associated with RALE scores (median [interquartile range]: 20.0[14.1-26.7], 26.0[20.5-34.0] and 44.5[34.5-48.0], respectively, p<0.0001). Among invasively-ventilated patients, RALE scores were significantly associated with worse respiratory mechanics (plateau and driving pressure) and gas exchange metrics (PaO2/FiO2 and ventilatory ratio), as well as higher plasma levels of IL-6, sRAGE and TNFR1 levels (p<0.05). RALE scores were independently associated with 90-day survival in a multivariate Cox proportional hazards model (adjusted hazard ratio 1.04[1.02-1.07], p=0.002). We validated significant associations of RALE scores with baseline severity and mortality in an independent dataset of 415 COVID-19 inpatients. CONCLUSION: Reproducible assessment of radiographic severity revealed significant associations with clinical and physiologic severity, host-response biomarkers and clinical outcome in COVID-19 pneumonia. Incorporation of radiographic severity assessments may provide prognostic and treatment allocation guidance in patients hospitalized with COVID-19.

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Emergency Department Chest X-ray Severity in Patients with COVID-19 Is Associated with Hypoxemia and Clinical Outcomes

Cited by 2 publications

References 0 publications

The Correlations Between Clinical Characteristics and Inflammation Markers with Chest X-rays in COVID-19 Patients at Ulin Hospital

The Correlations Between Clinical Characteristics and Inflammation Markers with Chest X-rays in COVID-19 Patients at Ulin Hospital

Radiographic Assessment of Lung Edema (RALE) Scores are Highly Reproducible and Prognostic of Clinical Outcomes for Inpatients with COVID-19

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