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DOI: 10.4103/ijri.IJRI_967_20
Role of chest radiography in the management of COVID-19 pneumonia: An overview and correlation with pathophysiologic changes
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Abstract
Background: Chest radiography (CXR) is a widely available baseline radiological modality in evaluating symptomatic patients with suspected or confirmed Covid-19 disease. Serial changes can help in monitoring the patients in conjunction with the clinical status of these patients in a hospital setting. Purpose: The purpose of this study was to analyse the patterns of radiological findings on chest radiograph (CXR) for suspected and confirmed COVID-19 patients on initial presentation to the emergency medical services (EMS) on admission and to assess the progression and resolution. Materials and Methods: In this study, patients who presented to EMS of a multispeciality hospital as suspected or confirmed Covid-19 on consecutive reverse transcriptase polymerase chain reaction (RT-PCR). CXR was examined for findings of haziness, patterns and distribution of opacities. Progression and regression of findings in serial CXR were studied and evaluated with the clinical and laboratory parameters. High resolution CT (HRCT) chest was performed initially for some patients. Results: 756 RT-PCR confirmed COVID-19 patients were included in our study who had initial CXR. 510 (67.46%) of our patients with positive initial RT-PCR showed abnormal baseline CXR. The abnormal findings were described as haziness akin to ground glass opacities (GGO) on CT, peripheral opacities, patchy parenchymal opacities and consolidation. Peripheral opacities and lower zone distribution were the commonest pattern of CXR abnormalities with bilateral involvement. The severity of findings on serial CXR and radiographic regression was studied along with follow-up to assess response to treatment. Forty-six patients showed features of acute lung injury (ALI). Complications and new CXR findings were reported for patients who were given ventilator support. Conclusion: CXR is a valuable baseline radiological investigation on hospital admission in symptomatic patients with suspected or confirmed Covid-19 presenting to the EMS as it helps to monitor the progress and regression of the disease in conjunction with clinical findings.
Publikationsverlauf
Eingereicht: 24. Dezember 2020
Angenommen: 31. Dezember 2020
Artikel online veröffentlicht:
13. Juli 2021
© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Jacobi A, Chung M, Bernheim A, Eber C. Portable chest X-ray in coronavirus disease-19 (COVID-19): A pictorial review. Clin Imaging 2020; 64: 35-42
- 2 Cevik M, Kuppalli K, Kindrachuk J, Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2. BMJ 2020; 371: m3862 DOI: 10.1136/bmj.m3862.
- 3 Rodrigues JC, Hare SS, Edey A, Devaraj A, Jacob J, Johnstone A. et al. An update on COVID-1 9 for the radiologist-A British society of Thoracic Imaging statement. Clin Radiol 2020; 75: 323-5
- 4 Tang X, Du R, Wang R, Cao TZ, Guan LL, Yang CQ. et al. Comparison of hospitalized patients with ARDS caused by covid-19 and H1N1. Chest 2020; 158 (01) 195-205
- 5 Wong HY, Lam HY, Fong AH, Leung ST, Chin TW, Lo CS. et al. Frequency and distribution of chest radiographic findings in COVID-19 positive patients. Radiology 2020:201160. Vol. 296, No. 2
- 6 Yasin R, Gouda W. Chest X-ray findings monitoring COVID-19 disease course and severity. Egypt J Radiol Nucl Med 2020; 51: 1-8
- 7 Durrani M, Inam ul Haq UK, Yousaf A. Chest X-rays findings in COVID 19 patients at an University Teaching Hospital-A descriptive study. Pak J Med Sci 2020; 36: S22
- 8 McGuinness G, Zhan C, Rosenberg N, Azour L, Wickstrom M, Mason DM. et al. Increased incidence of barotrauma in patients with COVID-19 on invasive mechanical ventilation. Radiology 2020; 297: E252-62
- 9 Sherren PB, Jovaisa T. Pulmonary interstitial emphysema presenting in a woman on the intensive care unit: Case report and review of literature. J Med Case Reports 2011; 236. 2011 Dec 1 5 (01) 236
- 10 Kouritas VK, Papagiannopoulos K, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V. et al. Pneumomediastinum. J Thorac Dis 2015; 7 (01) S44
- 11 Sun R, Liu H, Wang X. Mediastinal emphysema, Giant Bulla, and pneumothorax developed during the course of COVID-19 pneumonia. Korean J Radiol 2020; 21: 541-4
- 12 Hsu CW, Sun SF. Iatrogenic pneumothorax related to mechanical ventilation. World J Crit Care Med 2014; 3: 8-14
- 13 O’connor AR, Morgan WE. Radiological review of pneumothorax. BMJ 2005; 330: 1493-7
- 14 Jalota R, Sayad E. Tension pneumothorax. Stat Pearls [Internet] 2020 Jul 6.
- 15 Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med American Journal of respiratory and critical care medicine. 2002; 165 (07) 867-903
- 16 Magill SS, Li Q, Gross C, Dudeck M, Allen-Bridson K, Edwards JR. Incidence and characteristics of ventilator- associated events reported to the National Healthcare Safety Network in 2014. Crit Care Med 2016; 44: 2154-62
- 17 Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): A systematic review of imaging findings in 919 patients. AJR Am J Roentgenol 2020; 215: 87-93 DOI: 10.2214/AJR.20.23034. 2020;215(1):87-93 Epub 2020 Mar 14. PMID: 32174129
- 18 WHO/2019-nCoV/Clinical/Radiology/Radiology_imaging/2020.1.