The effect of bedside chest radiograph in the diagnosis and follow-up ofsevereand criticalCOVID-19

Abstract

Objective To explore the value of bedside chest radiograph in the diagnosis and follow-up of severe and critical COVID-19, and to improve the effect of bedside chest radiograph in the prevention and treatment of critical COVID-19. Methods Twenty-nine patients with COVID-19 were collected from January 23to February 23, 2020, fromfourCOVID-19 designated hospitals in Guangdong Province,which were clinically diagnosed as severe or critical COVID-19.Bedside radiography was taken in all the 29 patients, and thetotal number ranged from 1 to 16 times. Twenty-sevenpatients underwent follow-up, and the number of re-examination ranged 1 to 15 times, and the interval of review is 1 to 8 days.The imaging findings of bedside chest radiography and the imaging changes of follow-up were analyzed retrospectively. Results Twenty-nine patients were collected. The radiography showed the distribution of lesions was all more than 3 lung fields. Among them, 6 lung fields were found in 8 cases, 5 lung fields in 8 cases, 4 lung fields in 7 cases, 3 lung fields in 6 cases. The films showed consolidation shadow in 19 cases, multiple patches shadow in 23 cases, reticular pattern in 12 cases, strips shadow in 14 cases, interlobar fissure thickening in 18 cases, and "white lung" in 4 cases.The complications included pleural effusion in 4 cases, pneumothorax in 2 cases, mediastinal and subcutaneous emphysema in 1 case. The radiography showed the lesions increased in 15 cases, mainly showing the range of original lesions was enlarged, the density increasing in 6 cases, new lesionsfound in 5 cases, andboth of them found in 4 cases.Decreased in 9 cases, showing the range of lesions was reduced and the density was reduced. 8 cases showed patchy or consolidation shadow turned to strips shadow or articular pattern shadow.No significant change in 3 casesshowed large consolidation shadow. Conclusions Bedside chest radiography has a good value in the follow-up of severely and critically ill patients with COVID-19, and can provide great help for clinicians to evaluate their condition. Key words: COVID-19; Radiography