Role of chest radiography in COVID-19: A retrospective observational study in a tertiary care hospital in Southern India

Abstract

OBJECTIVES: The objective of this study is to evaluate the clinical profile of coronavirus disease-2019 (COVID-19) patients admitted to our hospital and to correlate their chest radiographic patterns with disease severity. MATERIALS AND METHODS: We retrospectively reviewed 500 patients with COVID-19 confirmed by reverse transcription-polymerase chain reaction who had abnormal baseline chest X-rays (CXRs) at the time of hospital admission. CXRs were characterized based on the site and nature of the lesions. Disease severity was determined using the Radiographic Assessment of Lung Edema (RALE) score. RESULTS: Significant associations were found between (1) the lesion site and patient outcome (P < 0.00001): patients with diffuse and basal infiltrates had high intensive care unit (ICU) admission rates (55.5% and 40%) and mortality rates (30.5% and 20%); (2) the nature of the lesion and patient outcome: patients with ground-glass opacities and consolidation had high mortality (20% and 18%, respectively); and (3) the RALE score and patient outcome: patients with a RALE score >15 had higher ICU admission and mortality rates. CONCLUSIONS: The CXR distribution patterns helped to triage patients and predict outcomes.