Abstract

When managing coronavirus disease 2019 (COVID-19) patients, radiological imaging complements clinical evaluation and laboratory parameters. We aimed to assess the sensitivity of chest radiography findings in detecting COVID-19, describe those findings, and assess the association of positive chest radiography findings with clinical and laboratory findings. A multicentre, cross-sectional study was conducted involving all primary health care corporation-registered patients (2485 patients) enrolled over a 1-month period during the peak of the 2020 pandemic wave in Qatar. These patients had reverse transcription-polymerase chain reaction-confirmed COVID-19 and underwent chest radiography within 72 hours of the swab test. A positive result on reverse transcription-polymerase chain reaction was the gold standard for diagnosing COVID-19. The sensitivity of chest radiography was calculated. The airspace opacities were mostly distributed in the peripheral and lower lung zones, and most of the patients had bilateral involvement. Pleural effusion was detected in some cases. The risk of having positive chest X-ray findings increased with age, Southeast Asian nationality, fever, or a history of fever and diarrhoea. Patients with cardiac disease, obesity, hypertension, diabetes, and chronic kidney disease were at a higher risk of having positive chest X-ray findings. There was a statistically significant increase in the mean serum albumin, white blood cell count, neutrophil count, and serum C-reactive protein, hepatic enzymes, and total bilirubin with an increase in the radiographic severity score.

Highlights

  • At the end of 2019, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spread from China to different parts of the world, and the ensuing pandemic was officially named coronavirus disease 19 (COVID-19)

  • If RT-PCR is not available or if the results are negative in symptomaticCOVID-19 patients, chest imaging is considered a part of the screening procedure for suspected COVID-19 cases [3]

  • The variables that were requested from the data custodian of the Primary Health Care Corporation (PHCC) were as follows: (1) the Visual Triage Checklist for COVID-19; (2) age, sex, and nationality of the patients to describe the demographics of the study population; (3) history of comorbidities for the following conditions: cardiac disease, hypertension, obesity, diabetes mellitus, liver disease, lung disease, oncologic history, and chronic kidney disease (CKD); (4) the available laboratory data that were completed within 72 h of the positive RT-PCR results—the laboratory data included albumin levels, white blood cell (WBC) count, lymphocyte count, C-reactive protein (CRP), creatine kinase levels, lactate dehydrogenase (LDH), and liver enzymes; and (5) chest X-ray (CXR) that were stored in the electronic health records system

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Summary

Introduction

At the end of 2019, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spread from China to different parts of the world, and the ensuing pandemic was officially named coronavirus disease 19 (COVID-19). If RT-PCR is not available or if the results are negative in symptomaticCOVID-19 patients, chest imaging is considered a part of the screening procedure for suspected COVID-19 cases [3]. Radiological imaging complements clinical evaluation and laboratory parameters for managing COVID-19 patients [4]. Computed tomography (CT) is specific and more sensitive (95%) than chest X-ray (CXR) for diagnosing this disease, and CT was used in China during the peak of the first wave of the pandemic [5, 6].

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