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The prognostic value of chest X-ray in patients with COVID-19 on admission and when starting CPAP.
Sargent, Will; Ali, Sajeed; Kukran, Sebi; Harvie, Miranda; Soin, Susanne.
  • Sargent W; Ealing Hospital, London, UK william.sargent@nhs.net.
  • Ali S; Ealing Hospital, London, UK.
  • Kukran S; Ealing Hospital, London, UK.
  • Harvie M; Ealing Hospital, London, UK.
  • Soin S; Ealing Hospital, London, UK.
Clin Med (Lond) ; 21(1): e14-e19, 2021 Jan.
Artículo en Inglés | 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. OUTCOME

MEASURES:

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.
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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Admisión del Paciente / Radiografía Torácica / Presión de las Vías Aéreas Positiva Contínua / Pandemias / SARS-CoV-2 / COVID-19 Tipo de estudio: Estudios diagnósticos / Estudio experimental / Estudio observacional / Estudio pronóstico Límite: Femenino / Humanos / Masculino / Middle aged Idioma: Inglés Revista: Clin Med (Lond) Año: 2021 Tipo del documento: Artículo País de afiliación: Clinmed.2020-0576

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Admisión del Paciente / Radiografía Torácica / Presión de las Vías Aéreas Positiva Contínua / Pandemias / SARS-CoV-2 / COVID-19 Tipo de estudio: Estudios diagnósticos / Estudio experimental / Estudio observacional / Estudio pronóstico Límite: Femenino / Humanos / Masculino / Middle aged Idioma: Inglés Revista: Clin Med (Lond) Año: 2021 Tipo del documento: Artículo País de afiliación: Clinmed.2020-0576