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Article: Frequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19

TitleFrequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19
Authors
Issue Date2020
PublisherRadiological Society of North America, Inc. The Journal's web site is located at http://radiology.rsnajnls.org
Citation
Radiology, 2020, v. 296 n. 2, p. E72-E78 How to Cite?
AbstractBackground: Current coronavirus disease 2019 (COVID-19) radiologic literature is dominated by CT, and a detailed description of chest radiography appearances in relation to the disease time course is lacking. Purpose: To describe the time course and severity of findings of COVID-19 at chest radiography and correlate these with real-time reverse transcription polymerase chain reaction (RT-PCR) testing for severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, nucleic acid. Materials and Methods: This is a retrospective study of patients with COVID-19 confirmed by using RT-PCR and chest radiographic examinations who were admitted across four hospitals and evaluated between January and March 2020. Baseline and serial chest radiographs (n = 255) were reviewed with RT-PCR. Correlation with concurrent CT examinations (n = 28) was performed when available. Two radiologists scored each chest radiograph in consensus for consolidation, ground-glass opacity, location, and pleural fluid. A severity index was determined for each lung. The lung scores were summed to produce the final severity score. Results: The study was composed of 64 patients (26 men; mean age, 56 years ± 19 [standard deviation]). Of these, 58 patients had initial positive findings with RT-PCR (91%; 95% confidence interval: 81%, 96%), 44 patients had abnormal findings at baseline chest radiography (69%; 95% confidence interval: 56%, 80%), and 38 patients had initial positive findings with RT-PCR testing and abnormal findings at baseline chest radiography (59%; 95% confidence interval: 46%, 71%). Six patients (9%) showed abnormalities at chest radiography before eventually testing positive for COVID-19 with RT-PCR. Sensitivity of initial RT-PCR (91%; 95% confidence interval: 83%, 97%) was higher than that of baseline chest radiography (69%; 95% confidence interval: 56%, 80%) (P = .009). Radiographic recovery (mean, 6 days ± 5) and virologic recovery (mean, 8 days ± 6) were not significantly different (P = .33). Consolidation was the most common finding (30 of 64; 47%) followed by ground-glass opacities (21 of 64; 33%). Abnormalities at chest radiography had a peripheral distribution (26 of 64; 41%) and lower zone distribution (32 of 64; 50%) with bilateral involvement (32 of 64; 50%). Pleural effusion was uncommon (two of 64; 3%). The severity of findings at chest radiography peaked at 10–12 days from the date of symptom onset. Conclusion: Findings at chest radiography in patients with coronavirus disease 2019 frequently showed bilateral lower zone consolidation, which peaked at 10–12 days from symptom onset.
Persistent Identifierhttp://hdl.handle.net/10722/281870
ISSN
2023 Impact Factor: 12.1
2023 SCImago Journal Rankings: 3.692
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, HYF-
dc.contributor.authorLam, HYS-
dc.contributor.authorFong, AHT-
dc.contributor.authorLeung, ST-
dc.contributor.authorChin, TWY-
dc.contributor.authorLo, CSY-
dc.contributor.authorLui, MMS-
dc.contributor.authorLee, JCY-
dc.contributor.authorChiu, KWH-
dc.contributor.authorChung, T-
dc.contributor.authorLee, EYP-
dc.contributor.authorWan, EYF-
dc.contributor.authorHung, FNI-
dc.contributor.authorLam, TPW-
dc.contributor.authorKuo, M-
dc.contributor.authorNg, MY-
dc.date.accessioned2020-04-03T07:22:56Z-
dc.date.available2020-04-03T07:22:56Z-
dc.date.issued2020-
dc.identifier.citationRadiology, 2020, v. 296 n. 2, p. E72-E78-
dc.identifier.issn0033-8419-
dc.identifier.urihttp://hdl.handle.net/10722/281870-
dc.description.abstractBackground: Current coronavirus disease 2019 (COVID-19) radiologic literature is dominated by CT, and a detailed description of chest radiography appearances in relation to the disease time course is lacking. Purpose: To describe the time course and severity of findings of COVID-19 at chest radiography and correlate these with real-time reverse transcription polymerase chain reaction (RT-PCR) testing for severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, nucleic acid. Materials and Methods: This is a retrospective study of patients with COVID-19 confirmed by using RT-PCR and chest radiographic examinations who were admitted across four hospitals and evaluated between January and March 2020. Baseline and serial chest radiographs (n = 255) were reviewed with RT-PCR. Correlation with concurrent CT examinations (n = 28) was performed when available. Two radiologists scored each chest radiograph in consensus for consolidation, ground-glass opacity, location, and pleural fluid. A severity index was determined for each lung. The lung scores were summed to produce the final severity score. Results: The study was composed of 64 patients (26 men; mean age, 56 years ± 19 [standard deviation]). Of these, 58 patients had initial positive findings with RT-PCR (91%; 95% confidence interval: 81%, 96%), 44 patients had abnormal findings at baseline chest radiography (69%; 95% confidence interval: 56%, 80%), and 38 patients had initial positive findings with RT-PCR testing and abnormal findings at baseline chest radiography (59%; 95% confidence interval: 46%, 71%). Six patients (9%) showed abnormalities at chest radiography before eventually testing positive for COVID-19 with RT-PCR. Sensitivity of initial RT-PCR (91%; 95% confidence interval: 83%, 97%) was higher than that of baseline chest radiography (69%; 95% confidence interval: 56%, 80%) (P = .009). Radiographic recovery (mean, 6 days ± 5) and virologic recovery (mean, 8 days ± 6) were not significantly different (P = .33). Consolidation was the most common finding (30 of 64; 47%) followed by ground-glass opacities (21 of 64; 33%). Abnormalities at chest radiography had a peripheral distribution (26 of 64; 41%) and lower zone distribution (32 of 64; 50%) with bilateral involvement (32 of 64; 50%). Pleural effusion was uncommon (two of 64; 3%). The severity of findings at chest radiography peaked at 10–12 days from the date of symptom onset. Conclusion: Findings at chest radiography in patients with coronavirus disease 2019 frequently showed bilateral lower zone consolidation, which peaked at 10–12 days from symptom onset.-
dc.languageeng-
dc.publisherRadiological Society of North America, Inc. The Journal's web site is located at http://radiology.rsnajnls.org-
dc.relation.ispartofRadiology-
dc.titleFrequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19-
dc.typeArticle-
dc.identifier.emailFong, AHT: ahtfong@hku.hk-
dc.identifier.emailChiu, KWH: kwhchiu@hku.hk-
dc.identifier.emailLee, EYP: eyplee77@hku.hk-
dc.identifier.emailWan, EYF: yfwan@hku.hk-
dc.identifier.emailHung, FNI: ivanhung@hkucc.hku.hk-
dc.identifier.emailKuo, M: mdkuo@hku.hk-
dc.identifier.emailNg, MY: myng2@hku.hk-
dc.identifier.authorityChiu, KWH=rp02074-
dc.identifier.authorityLee, EYP=rp01456-
dc.identifier.authorityWan, EYF=rp02518-
dc.identifier.authorityHung, FNI=rp00508-
dc.identifier.authorityNg, MY=rp01976-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1148/radiol.2020201160-
dc.identifier.pmid32216717-
dc.identifier.pmcidPMC7233401-
dc.identifier.scopuseid_2-s2.0-85083098375-
dc.identifier.hkuros309609-
dc.identifier.volume296-
dc.identifier.issue2-
dc.identifier.spageE72-
dc.identifier.epageE78-
dc.identifier.isiWOS:000551892700008-
dc.publisher.placeUnited States-
dc.identifier.issnl0033-8419-

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