The prognostic value of chest X-ray in patients with COVID-19 on admission and when starting CPAP.
Clin Med (Lond)
; 21(1): e14-e19, 2021 Jan.
Article
in English
| MEDLINE | ID: covidwho-1043992
ABSTRACT
OBJECTIVE:
The objective was to explore if chest X-ray severity, assessed using a validated scoring system, predicts patient outcome on admission and when starting continuous positive pressure ventilation (CPAP) for COVID-19.DESIGN:
The study was a retrospective case-controlled study.PARTICIPANTS:
There were 163 patients with COVID-19 deemed candidates for CPAP on admission, including 58 who subsequently required CPAP. OUTCOMEMEASURES:
On admission, we measured the proportion of patients meeting a composite 'negative' outcome of requiring CPAP, intubation or dying versus successful ward-based care. For those escalated to CPAP, 'negative' outcomes were intubation or death versus successful de-escalation of respiratory support.RESULTS:
Our results were stratified into tertiles, those with 'moderate' or 'severe' X-rays on admission had significantly higher odds of negative outcome versus 'mild' (odds ratio (OR) 2.32; 95% confidence interval (CI) 1.121-4.803; p=0.023; and OR 3.600; 95% CI 1.681-7.708; p=0.001, respectively). This could not be demonstrated in those commencing CPAP (OR 0.976; 95% CI 0.754-1.264; p=0.856).CONCLUSIONS:
We outline a scoring system to stratify X-rays by severity and directly link this to prognosis. However, we were unable to demonstrate this association in the patients commencing CPAP.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Patient Admission
/
Radiography, Thoracic
/
Continuous Positive Airway Pressure
/
Pandemics
/
SARS-CoV-2
/
COVID-19
Type of study:
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Clin Med (Lond)
Year:
2021
Document Type:
Article
Affiliation country:
Clinmed.2020-0576
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