Role of portable chest radiography in management of COVID-19: Experience of 422 patients from a tertiary care center in India

• Published in: The Indian journal of radiology & imaging Vol. 31; no. S 01; pp. S94 - S100
• Main Authors: Goyal, Alka, Tiwari, Raghav, Bagarhatta, Meenu, Ashwini, B, Rathi, Bhavyansh, Bhandari, Sudhir
• Format: Journal Article
• Language: English
• Published: A-12, Second Floor, Sector -2, NOIDA -201301, India Thieme Medical and Scientific Publishers Private Ltd 01-01-2021; Wolters Kluwer India Pvt. Ltd; Medknow Publications and Media Pvt. Ltd; Georg Thieme Verlag Stuttgart; Wolters Kluwer - Medknow; Thieme Medical and Scientific Publishers Pvt. Ltd
• Subjects: Analysis; Bacterial pneumonia; Chest; Computed tomography; Coronaviruses; COVID-19; CT imaging; ct-computed tomography; cxr-chest radiography; Development and progression; ggo-ground glass opacity; Hospitalization; Lungs; Original; Original Article; Pneumonia; Portability; Radiographs; Radiography; Risk factors; rt-pcr – reverse transcriptase polymerase chain reaction; Viral diseases; India; RT-PCR – reverse transcriptase polymerase chain reaction; CT-computed tomography; GGO-ground glass opacity; CXR-chest radiography
• ISSN: 0971-3026; 0970-2016; 1998-3808; 0971-3026
• DOI: 10.4103/ijri.IJRI_480_20

Abstract
Objective
: To analyze radiological changes in portable chest radiographs in coronavirus disease-19(COVID-19) patients to optimize the management of hospitalized patients.
Methods
: We retrospectively reviewed 638 portable radiographs of 422 hospitalized COVID-19 patients with RT-PCR confirmed COVID-19 infection. All the radiographs were reported in a structured format by two experienced radiologists. A severity score was assigned to every Chest Xray (CXR) and correlation was done with the CT scans whenever available.
Results
: Out of 422 baseline portable radiographs assessed,
th
e ratio of male: female patients was 337:85 that is 79.8% were males and 20.14% were females.The mean age was 50.5 years and the range was 17–84 years.Of these 422 patients, 187 patients (44.3%) had abnormal baseline CXR. 161 out of 187 (86%) had either typical or indeterminate findings for COVID-19 pneumonia, rest 26 (13.9%) patients had CXR findings not consistent with COVID-19, like pleural effusion, hydropneumothorax, or lung cavity.Most commonly observed CXR findings in COVID 19 pneumonia were bilateral, multifocal air space opacities (consolidation and ground-glass opacities) predominantly involving lower zones and peripheral lung fields. X-ray identifiable lung changes of COVID-19 were mostly seen at 9-11 days after symptom onset.
Conclusion
: The presence of multifocal air-space opacities with bilateral, peripheral distribution on chest radiograph is highly suggestive of COVID-19 pneumonia in this pandemic setting.Portable chest radiography is a widely available and quicktool for estimating the evolution and assessing the severity of lung involvement of COVID-19 pneumonia in hospitalized symptomatic patients.