Sean Wei Xiang Ong1,2, Terrence Chi Hong Hui3, Yeong Shyan Lee3, Salahudeen Mohamed Haja Mohideen4, Barnaby Edward Young1,2,5, Cher Heng Tan3,5, David Chien Lye1,2,5,6. 1. National Centre for Infectious Diseases, Singapore, Singapore. 2. Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore. 3. Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore. 4. Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore. 5. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. 6. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Abstract
OBJECTIVES: High-risk CXR features in COVID-19 are not clearly defined. We aimed to identify CXR features that correlate with severe COVID-19. METHODS: All confirmed COVID-19 patients admitted within the study period were screened. Those with suboptimal baseline CXR were excluded. CXRs were reviewed by three independent radiologists and opacities recorded according to zones and laterality. The primary endpoint was defined as hypoxia requiring supplemental oxygen, and CXR features were assessed for association with this endpoint to identify high-risk features. These features were then used to define criteria for a high-risk CXR, and clinical features and outcomes of patients with and without baseline high-risk CXR were compared using logistic regression analysis. RESULTS: 109 patients were included. In the initial analysis of 40 patients (36.7%) with abnormal baseline CXR, presence of bilateral opacities, multifocal opacities, or any upper or middle zone opacity were associated with supplemental oxygen requirement. Of the entire cohort, 29 patients (26.6%) had a baseline CXR with at least one of these features. Having a high-risk baseline CXR was significantly associated with requiring supplemental oxygen in univariate (odds ratio 14.0, 95% confidence interval 3.90-55.60) and multivariate (adjusted odds ratio 8.38, 95% CI 2.43-28.97, P = 0.001) analyses. CONCLUSION: We identified several high-risk CXR features that are significantly associated with severe illness. The association of upper or middle zone opacities with severe illness has not been previously emphasized. Recognition of these specific high-risk CXR features is important to prioritize limited healthcare resources for sicker patients.
OBJECTIVES: High-risk CXR features in COVID-19 are not clearly defined. We aimed to identify CXR features that correlate with severe COVID-19. METHODS: All confirmed COVID-19patients admitted within the study period were screened. Those with suboptimal baseline CXR were excluded. CXRs were reviewed by three independent radiologists and opacities recorded according to zones and laterality. The primary endpoint was defined as hypoxia requiring supplemental oxygen, and CXR features were assessed for association with this endpoint to identify high-risk features. These features were then used to define criteria for a high-risk CXR, and clinical features and outcomes of patients with and without baseline high-risk CXR were compared using logistic regression analysis. RESULTS: 109 patients were included. In the initial analysis of 40 patients (36.7%) with abnormal baseline CXR, presence of bilateral opacities, multifocal opacities, or any upper or middle zone opacity were associated with supplemental oxygen requirement. Of the entire cohort, 29 patients (26.6%) had a baseline CXR with at least one of these features. Having a high-risk baseline CXR was significantly associated with requiring supplemental oxygen in univariate (odds ratio 14.0, 95% confidence interval 3.90-55.60) and multivariate (adjusted odds ratio 8.38, 95% CI 2.43-28.97, P = 0.001) analyses. CONCLUSION: We identified several high-risk CXR features that are significantly associated with severe illness. The association of upper or middle zone opacities with severe illness has not been previously emphasized. Recognition of these specific high-risk CXR features is important to prioritize limited healthcare resources for sicker patients.
Authors: Vo Tan Duc; Tran Thi Mai Thuy; Nguyen Hoang Nam; Ha Thi Bich Tram; Truong Thi Phuong Thao; Lam Thuy Doan; Le Nguyen Gia Hy; Le Nguyen Diem Quynh; Nguyen Hong Duc; Le Minh Thang; Le Duy Mai Huyen; Phan Cong Chien; Le Huu Hanh Nhi; Uyen Do; Le Huu Nhat Minh Journal: Cureus Date: 2022-05-09
Authors: Eduardo López-Medina; German Camacho-Moreno; Martin E Brizuela; Diana M Dávalos; Juan Pablo Torres; Rolando Ulloa-Gutierrez; Pio López; Roberto Debbag; Paola Pérez; Jaime Patiño; Ximena Norero; Cristina Mariño; Miguel A Luengas; Gabriela Ensinck; Carlos Daza; Kathia Luciani; Paola Quintana Kuhner; Mónica Rodriguez; Juan Pablo Rodríguez-Auad; Alejandra Estrada-Villarroel; Mayli Carnevale; Orlando Cesar Mantese; Eitan N Berezin; José Iván Castillo; Abiel Mascareñas; Andrea Jimenez-Zambrano; Lourdes Dueñas; Mario Melgar; Nancy Galvez; Erika Cantor; Edwin J Asturias Journal: Front Pediatr Date: 2022-04-14 Impact factor: 3.569
Authors: Chan Mi Lee; Eunyoung Lee; Wan Beom Park; Pyoeng Gyun Choe; Kyoung-Ho Song; Eu Suk Kim; Sang-Won Park Journal: J Korean Med Sci Date: 2022-08-15 Impact factor: 5.354