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Utility of Screening Chest Radiographs in Patients with Asymptomatic or Minimally Symptomatic COVID-19 in Singapore.
Kuo, Benjamin J; Lai, Yusheng Keefe; Tan, Ming Loong Mark; Goh, Xian-Yang Charles.
  • Kuo BJ; From the Department of Diagnostic Radiology, Division of Radiological Sciences (B.J.K., Y.K.L.), and Department of Nuclear Medicine and Molecular Imaging (X.Y.C.G.), Singapore General Hospital, 20 College Rd, Singapore 169608; SATA CommHealth, Singapore, Singapore (M.L.M.T.).
  • Lai YK; From the Department of Diagnostic Radiology, Division of Radiological Sciences (B.J.K., Y.K.L.), and Department of Nuclear Medicine and Molecular Imaging (X.Y.C.G.), Singapore General Hospital, 20 College Rd, Singapore 169608; SATA CommHealth, Singapore, Singapore (M.L.M.T.).
  • Tan MLM; From the Department of Diagnostic Radiology, Division of Radiological Sciences (B.J.K., Y.K.L.), and Department of Nuclear Medicine and Molecular Imaging (X.Y.C.G.), Singapore General Hospital, 20 College Rd, Singapore 169608; SATA CommHealth, Singapore, Singapore (M.L.M.T.).
  • Goh XC; From the Department of Diagnostic Radiology, Division of Radiological Sciences (B.J.K., Y.K.L.), and Department of Nuclear Medicine and Molecular Imaging (X.Y.C.G.), Singapore General Hospital, 20 College Rd, Singapore 169608; SATA CommHealth, Singapore, Singapore (M.L.M.T.).
Radiology ; 298(3): E131-E140, 2021 03.
Article in English | MEDLINE | ID: covidwho-963850
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Chest radiograph NEG_ADMINISTERED_TO Patients
Subject
Chest radiograph
Predicate
NEG_ADMINISTERED_TO
Object
Patients
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Chest radiograph NEG_ADMINISTERED_TO Patients
Subject
Chest radiograph
Predicate
NEG_ADMINISTERED_TO
Object
Patients
ABSTRACT
Background Singapore saw an escalation of coronavirus disease 2019 (COVID-19) cases from fewer than 4000 in April 2020 to more than 40 000 in June 2020, with most of these cases attributed to spread within shared facilities housing foreign workers. Appropriate triage and escalation of clinical care are crucial for this patient group managed in community care facilities (CCFs). Purpose To evaluate the imaging guideline recommendations for COVID-19 from the Fleischner Society and to analyze the clinical utility of screening chest radiography for asymptomatic or minimally symptomatic patients with COVID-19. Materials and Methods In this retrospective study, patients with reverse-transcription polymerase chain reaction-confirmed COVID-19 who were admitted to a designated CCF for continuation of their treatment during May 3-31, 2020, were identified. Upon admission, patients aged 36 years and older without any baseline chest images underwent chest radiography. All chest radiographs and clinical outcomes of patients, including those who were subsequently transferred to acute hospitals for escalation of care, were reviewed. Key proportions of patients with findings of pulmonary infection and those requiring further inpatient treatment were calculated, and 95% binomial proportion CIs were obtained using the Clopper-Pearson method. Results The study included 5621 patients. All patients were men (100%; 5621 of 5621), and the mean patient age was 37 years ± 8 (range, 17-60 years). A total of 1964 chest radiographs were obtained, of which normal images accounted for 98.0% (1925 of 1964 radiographs) and findings of pulmonary infection represented 2.0% (39 of 1964 radiographs). Only 0.2% of patients (four of 1964) with findings of pulmonary infection at chest radiography (all of whom were symptomatic) required supplemental oxygenation and inpatient treatment. None of the asymptomatic patients with findings of pulmonary infection required supplemental oxygenation, and they received only symptomatic treatment. Conclusion In accordance with Fleischner Society recommendations, screening chest radiography is not indicated in patients with coronavirus disease 2019 who are aged 17-60 years with mild or no symptoms unless there is risk of clinical deterioration. © RSNA, 2021 See also the editorial by Schaefer-Prokop and Prokop in this issue.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Radiography / COVID-19 / Lung Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Adult / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Asia Language: English Journal: Radiology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Radiography / COVID-19 / Lung Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Adult / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Asia Language: English Journal: Radiology Year: 2021 Document Type: Article