Abstract
Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic with lung disease representing the main cause of morbidity and mortality. Conventional chest-X ray (CXR) and ultrasound (US) are valuable instruments to assess the extent of lung involvement. We investigated the relationship between CXR scores on admission and the level of medical care required in patients with COVID-19. Further, we assessed the CXR-US correlation to explore the role of ultrasound in monitoring the course of COVID-19 pneumonia. Clinical features and CXR scores were obtained at admission and correlated with the level of intensity of care required [high- (HIMC) versus low-intensity medical care (LIMC)]. In a subgroup of patients, US findings were correlated with clinical and radiographic parameters. On hospital admission, CXR global score was higher in HIMCs compared to LIMC. Smoking history, pO2 on admission, cardiovascular and oncologic diseases were independent predictors of HIMC. The US score was positively correlated with FiO2 while the correlation with CXR global score only trended towards significance. Our study identifies clinical and radiographic features that strongly correlate with higher levels of medical care. The role of lung ultrasound in this setting remains undetermined and needs to be explored in larger prospective studies.
Highlights
Since December 2019, when the first cases of coronavirus disease 2019 (COVID-19) were reported, the diffusion of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has rapidly spread from the Hubei Province in China to involve up to 213 states and territories to date, reaching pandemic proportions [1]
Despite epidemiological reports showing that approximately half of the infected people are asymptomatic [1], the spectrum of respiratory manifestations may range from mild symptoms, such as dry cough, fever, and fatigue, to acute respiratory distress syndrome (ARDS), requiring admission to intensive care unit (ICU) and mechanical ventilation (MV)
We investigated the relationship between chest X-ray (CXR) severity score on admission and the level of medical care required in patients with COVID-19
Summary
Since December 2019, when the first cases of coronavirus disease 2019 (COVID-19) were reported, the diffusion of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has rapidly spread from the Hubei Province in China to involve up to 213 states and territories to date, reaching pandemic proportions [1]. Despite epidemiological reports showing that approximately half of the infected people are asymptomatic [1], the spectrum of respiratory manifestations may range from mild symptoms, such as dry cough, fever, and fatigue, to acute respiratory distress syndrome (ARDS), requiring admission to intensive care unit (ICU) and mechanical ventilation (MV). In this scenario, thoracic radiology plays a key role in early detection of lung involvement from COVID-19. We assessed the radiographic–ultrasound correlation with the aim to explore the value of ultrasound in monitoring the course of COVID-19 pneumonia
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