Evaluation of Admission Chest X-Ray Findings in Patients With Respiratory Infection During the COVID-19 Pandemic

Velissaris, Dimitrios; Lagadinou, Maria; Paraskevas, Themistoklis; Oikonomou, Eleousa; Karamouzos, Vasileios; Sampsonas, Fotios; Marangos, Markos; Καρανικόλας, Μενέλαος

doi:10.7759/cureus.18114

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…Other authors [20], by enrolling 117 patients suspected of SARS-CoV-2 pneumonia and hospitalized with lower respiratory tract symptoms, demonstrated that CXR findings were significantly more evident in patients affected with COVID-19 when compared with the non-COVID-19 group (83 vs. 42%, p < 0.001). Moreover, the authors reported that CXR abnormalities observed during admission could be considered as predictors for prognosis; patients with abnormal CXR findings reported significantly higher mortality (p = 0.0014).…”

Section: Chest X-ray (Cxr)mentioning

confidence: 99%

Role of Imaging in the Management of Patients with SARS-CoV-2 Lung Involvement Admitted to the Emergency Department: A Systematic Review

et al. 2023

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During the waves of the coronavirus disease (COVID-19) pandemic, emergency departments were overflowing with patients suffering with suspected medical or surgical issues. In these settings, healthcare staff should be able to deal with different medical and surgical scenarios while protecting themselves against the risk of contamination. Various strategies were used to overcome the most critical issues and guarantee quick and efficient diagnostic and therapeutic charts. The use of saliva and nasopharyngeal swab Nucleic Acid Amplification Tests (NAAT) in the diagnosis of COVID-19 was one of the most adopted worldwide. However, NAAT results were slow to report and could sometimes create significant delays in patient management, especially during pandemic peaks. On these bases, radiology has played and continues to play an essential role in detecting COVID-19 patients and solving differential diagnosis between different medical conditions. This systematic review aims to summarize the role of radiology in the management of COVID-19 patients admitted to emergency departments by using chest X-rays (CXR), computed tomography (CT), lung ultrasounds (LUS), and artificial intelligence (AI).

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Section: Chest X-ray (Cxr)mentioning

confidence: 99%

Role of Imaging in the Management of Patients with SARS-CoV-2 Lung Involvement Admitted to the Emergency Department: A Systematic Review

et al. 2023

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“…In established clinical practice, the presence of chest X-ray (CXR) abnormalities provides radiological confirmation of pneumonia [ 8 ], which is also an independent risk factor for adverse clinical outcomes in COVID-19 patients [ 9 , 10 , 11 , 12 ]. Whilst CXR findings such as ground glass changes and consolidation are common in acute COVID-19 patients, a significant proportion of patients can also present with normal CXRs [ 10 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Low CRB-65 Scores Effectively Rule out Adverse Clinical Outcomes in COVID-19 Irrespective of Chest Radiographic Abnormalities

Liu,

Hammond,

Chan

et al. 2023

Biomedicines

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Background: CRB-65 (Confusion; Respiratory rate ≥ 30/min; Blood pressure ≤ 90/60 mmHg; age ≥ 65 years) is a risk score for prognosticating patients with COVID-19 pneumonia. However, a significant proportion of COVID-19 patients have normal chest X-rays (CXRs). The influence of CXR abnormalities on the prognostic value of CRB-65 is unknown, limiting its wider applicability. Methods: We assessed the influence of CXR abnormalities on the prognostic value of CRB-65 in COVID-19. Results: In 589 study patients (71 years (IQR: 57–83); 57% males), 186 (32%) had normal CXRs. On ROC analysis, CRB-65 performed similarly in patients with normal vs. abnormal CXRs for predicting inpatient mortality (AUC 0.67 ± 0.05 vs. 0.69 ± 0.03). In patients with normal CXRs, a CRB-65 of 0 ruled out mortality, NIV requirement and critical illness (intubation and/or ICU admission) with negative predictive values (NPVs) of 94%, 98% and 99%, respectively. In patients with abnormal CXRs, a CRB-65 of 0 ruled out the same endpoints with NPVs of 91%, 83% and 86%, respectively. Patients with low CRB-65 scores had better inpatient survival than patients with high CRB-65 scores, irrespective of CXR abnormalities (all p < 0.05). Conclusions: CRB-65, CXR and CRP are independent predictors of mortality in COVID-19. Adding CXR findings (dichotomised to either normal or abnormal) to CRB-65 does not improve its prognostic accuracy. A low CRB-65 score of 0 may be a good rule-out test for adverse clinical outcomes in COVID-19 patients with normal or abnormal CXRs, which deserves prospective validation.

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Evaluation of Admission Chest X-Ray Findings in Patients With Respiratory Infection During the COVID-19 Pandemic

Cited by 2 publications

References 11 publications

Role of Imaging in the Management of Patients with SARS-CoV-2 Lung Involvement Admitted to the Emergency Department: A Systematic Review

Role of Imaging in the Management of Patients with SARS-CoV-2 Lung Involvement Admitted to the Emergency Department: A Systematic Review

Low CRB-65 Scores Effectively Rule out Adverse Clinical Outcomes in COVID-19 Irrespective of Chest Radiographic Abnormalities

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