This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Chest X-Ray findings and visual quantitative assessment of COVID-19 pneumonia
Michaela Cellina
ASST Fatebenefratelli Sacco
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Aim
To assess the most common chest X-Ray findings and distribution in patients with confirmed diagnosis of COVID-19; to verify the repeatability of a radiological severity score, based on visual quantitative assessment; to assess the evolution of chest X-Ray findings at follow-up; to evaluate chest X-Ray sensitivity.
Methods
We analysed chest X-Rays at baseline of 110 consecutive COVID-19 patients (79 males, 31 females; mean age: 64±16 years) with RT-PCR confirmation, who presented to our ED.
Two radiologists evaluated the imaging findings and distribution.
A severity score, based on the extension of lung abnormalities, was assigned by two other radiologists, independently, to the baseline and follow-up X-Rays, executed in 77/110 cases; interobserver agreement was calculated. Chest X-Ray sensitivity was assessed, with RT-PCR as gold standard.
Results
Interobserver agreement was excellent for baseline and follow-up X-Rays (Cohen's K=0.989, p<0.001, Cohen's K=0.985, p<0.001, respectively). The mean score at baseline was 2.87±1.7 for readers 1 and 2. We observed radiological worsening in 52/77 (67%) patients, with significantly higher scores at follow-up (mean score: 4.27±2.15 for reader 1 and 4.28±2.14 for reader 2, respectively); p<0.001.
Ground glass opacities were the most common findings (97/110, 88%). Abnormalities showed bilateral involvement in 67/110 (61%), with prevalent peripheral distribution (48/110, 43.5%).
The X-Ray sensitivity for the detection of COVID-19 infection was 91%.
Conclusion
Chest X-Ray highlighted imaging findings in line with those previously reported for chest CT. The use of a radiological score can result in clearer communication with Clinicians and a more precise assessment of disease evolution.
Keywords
Pneumonia, Viral, X-Rays, COVID-19, severe acute respiratory syndrome coronavirus 2, Radiography
Figure 1
Figure 2
Figure 3
Figure 4
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 29 May, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Nuclear Medicine & Medical Imaging
Learn more about our company.
This is a preprint. It has not completed peer review.
Research Article
Chest X-Ray findings and visual quantitative assessment of COVID-19 pneumonia
Michaela Cellina
ASST Fatebenefratelli Sacco
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 29 May, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Nuclear Medicine & Medical Imaging
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Aim
To assess the most common chest X-Ray findings and distribution in patients with confirmed diagnosis of COVID-19; to verify the repeatability of a radiological severity score, based on visual quantitative assessment; to assess the evolution of chest X-Ray findings at follow-up; to evaluate chest X-Ray sensitivity.
Methods
We analysed chest X-Rays at baseline of 110 consecutive COVID-19 patients (79 males, 31 females; mean age: 64±16 years) with RT-PCR confirmation, who presented to our ED.
Two radiologists evaluated the imaging findings and distribution.
A severity score, based on the extension of lung abnormalities, was assigned by two other radiologists, independently, to the baseline and follow-up X-Rays, executed in 77/110 cases; interobserver agreement was calculated. Chest X-Ray sensitivity was assessed, with RT-PCR as gold standard.
Results
Interobserver agreement was excellent for baseline and follow-up X-Rays (Cohen's K=0.989, p<0.001, Cohen's K=0.985, p<0.001, respectively). The mean score at baseline was 2.87±1.7 for readers 1 and 2. We observed radiological worsening in 52/77 (67%) patients, with significantly higher scores at follow-up (mean score: 4.27±2.15 for reader 1 and 4.28±2.14 for reader 2, respectively); p<0.001.
Ground glass opacities were the most common findings (97/110, 88%). Abnormalities showed bilateral involvement in 67/110 (61%), with prevalent peripheral distribution (48/110, 43.5%).
The X-Ray sensitivity for the detection of COVID-19 infection was 91%.
Conclusion
Chest X-Ray highlighted imaging findings in line with those previously reported for chest CT. The use of a radiological score can result in clearer communication with Clinicians and a more precise assessment of disease evolution.
Figure 1
Figure 2
Figure 3
Figure 4