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Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Clin+Imaging 2021 ; 71 (ä): 17-23 Nephropedia Template TP
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Correlation of chest radiography findings with the severity and progression of COVID-19 pneumonia #MMPMID33166898
Al-Smadi AS; Bhatnagar A; Ali R; Lewis N; Johnson S
Clin Imaging 2021[Mar]; 71 (ä): 17-23 PMID33166898show ga
PURPOSE: Aim is to assess the temporal changes and prognostic value of chest radiograph (CXR) in COVID-19 patients. MATERIAL AND METHODS: We performed a retrospective study of confirmed COVID-19 patients presented to the emergency between March 07-17, 2020. Clinical & radiological findings were reviewed. Clinical outcomes were classified into critical & non-critical based on severity. Two independent radiologists graded frontal view CXRs into COVID-19 pneumonia category 1 (CoV-P1) with <4 zones and CoV-P2 with >/=4 zones involvement. Interobserver agreement of CoV-P category for the CXR preceding the clinical outcome was assessed using Kendall's tau coefficient. Association between CXR findings and clinical deterioration was calculated along with temporal changes of CXR findings with disease progression. RESULTS: Sixty-two patients were evaluated for clinical features. 56 of these (total: 325 CXRs) were evaluated for radiological findings. Common patterns were progression from lower to upper zones, peripheral to diffuse involvement, & from ground glass opacities to consolidation. Consolidations starting peripherally were noted in 76%, 93% and 48% with critical outcomes, respectively. The interobserver agreement of the CoV-P category of CXRs in the critical and non-critical outcome groups were good and excellent, respectively (tau coefficient = 0.6 & 1.0). Significant association was observed between CoV-P2 and clinical deterioration into a critical status (chi2 = 27.7, p = 0.0001) with high sensitivity (95%) and specificity (71%) within a median interval time of 2 days (range: 0-4 days). CONCLUSION: Involvement of predominantly 4 or more zones on frontal chest radiograph can be used as predictive prognostic indicator of poorer outcome in COVID-19 patients.