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Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: an observational retrospective analysis of the relationship between radiological, clinical, and laboratory data.
Baratella, Elisa; Crivelli, Paola; Marrocchio, Cristina; Bozzato, Alessandro Marco; Vito, Andrea De; Madeddu, Giordano; Saderi, Laura; Confalonieri, Marco; Tenaglia, Luigi; Cova, Maria Assunta.
  • Baratella E; . Dipartimento di Radiologia, Università degli Studi di Trieste, Trieste, Italia.
  • Crivelli P; . Diagnostica per immagini 2, AOU Sassari, Sassari, Italia.
  • Marrocchio C; . Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Università degli Studi di Trieste, Trieste, Italia.
  • Bozzato AM; . Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Università degli Studi di Trieste, Trieste, Italia.
  • Vito A; . Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Università degli Studi di Sassari, Sassari, Italia.
  • Madeddu G; . Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Università degli Studi di Sassari, Sassari, Italia.
  • Saderi L; . Unità di Epidemiologia Clinica e Statistica Medica, Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università degli Studi di Sassari, Sassari, Italia.
  • Confalonieri M; . Dipartimento di Pneumologia, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italia.
  • Tenaglia L; . Dipartimento ad Attività Integrata di Emergenza, Urgenza ed Accettazione, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italia.
  • Cova MA; . Dipartimento di Radiologia, Università degli Studi di Trieste, Trieste, Italia.
J Bras Pneumol ; 46(5): e20200226, 2020.
Article in English, Portuguese | MEDLINE | ID: covidwho-790252
ABSTRACT

OBJECTIVE:

To investigate the diagnostic accuracy of a chest X-ray (CXR) score and of clinical and laboratory data in predicting the clinical course of patients with SARS coronavirus 2 (SARS-CoV-2) infection.

METHODS:

This is a pilot multicenter retrospective study including patients with SARS-CoV-2 infection admitted to the ERs in three hospitals in Italy between February and March of 2020. Two radiologists independently evaluated the baseline CXR of the patients using a semi-quantitative score to determine the severity of lung involvement a score of 0 represented no lung involvement, whereas scores of 1 to 4 represented the first (less severe) to the fourth (more severe) quartiles regarding the severity of lung involvement. Relevant clinical and laboratory data were collected. The outcome of patients was defined as severe if noninvasive ventilation (NIV) or intubation was necessary, or if the patient died.

RESULTS:

Our sample comprised 140 patients. Most of the patients were symptomatic (132/138; 95.7%), and 133/140 patients (95.0%) presented with opacities on CXR at admission. Of the 140 patients, 7 (5.0%) showed no lung involvement, whereas 58 (41.4%), 31 (22.1%), 26 (18.6%), and 18 (12.9%), respectively, scored 1, 2, 3, and 4. In our sample, 66 patients underwent NIV or intubation, 37 of whom scored 1 or 2 on baseline CXR, and 28 patients died.

CONCLUSIONS:

The severity score based on CXR seems to be able to predict the clinical progression in cases that scored 0, 3, or 4. However, the score alone cannot predict the clinical progression in patients with mild-to-moderate parenchymal involvement (scores 1 and 2).
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Radiography, Thoracic / Coronavirus Infections / Pandemics / Lung Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English / Portuguese Journal: J Bras Pneumol Year: 2020 Document Type: Article Affiliation country: 1806-3756

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Radiography, Thoracic / Coronavirus Infections / Pandemics / Lung Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English / Portuguese Journal: J Bras Pneumol Year: 2020 Document Type: Article Affiliation country: 1806-3756