Abstract
The purpose of this study was to compare the prognostic value of chest X-ray (CXR) and chest computed tomography (CT) in a group of hospitalized patients with COVID-19. For this study, we retrospectively selected a cohort of 106 hospitalized patients with COVID-19 who underwent both CXR and chest CT at admission. For each patient, the pulmonary involvement was ranked by applying the Brixia score for CXR and the percentage of well-aerated lung (WAL) for CT. The Brixia score was assigned at admission (A-Brixia score) and during hospitalization. During hospitalization, only the highest score (H-Brixia score) was considered. At admission, the percentage of WAL (A-CT%WAL) was quantified using a dedicated software. On logistic regression analyses, H-Brixia score was the most effective radiological marker for predicting in-hospital mortality and invasive mechanical ventilation. Additionally, A-CT%WAL did not provide substantial advantages in the risk stratification of hospitalized patients with COVID-19 compared to A-Brixia score.
Highlights
Ten months after the start of coronavirus disease (COVID19) vaccination planning, the diffusion and virulence of the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) are progressively decreasing in many parts of the world
For symptomatic patients with COVID-19, the World Health Organization (WHO) recommends chest imaging in addition to clinical and laboratory examinations to decide between patient discharge and hospitalization or to identify patients requiring specific therapeutic management [3]
One of the most challenging questions about chest imaging in symptomatic patients with COVID-19 is which imaging modalities between chest X-ray (CXR) and chest computed tomography (CT) are the most effective for improving risk stratification of infected patients and predicting disease progression
Summary
Ten months after the start of coronavirus disease (COVID19) vaccination planning, the diffusion and virulence of the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) are progressively decreasing in many parts of the world. On October 21, 2021, the number of new SARSCoV2 infections in Italy was 3794, with 22 new admissions to intensive care units (ICUs), and 36 new deaths. There was a decrease in new infections by 90.7%, in new admissions to ICU by 63.3% for new admissions to ICUs, and in new deaths by 93.5% as compared to the peak of incidence observed on November 13, 2020 during the second wave of COVID-19 in Italy [1, 2]. Despite the progressive reduction in hospitalization and fatality rates in patients with COVID-19, ICU admissions and deaths are still observed [1]. The aim of the present study was to retrospectively compare the prognostic value of CXR and chest CT at admission and during hospitalization in a group of patients with COVID-19
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