Abstract
Introduction Chest X-ray (CXR) is used for the initial triage of patients with suspected COVID-19. Studies of CXR scoring in the European population found a higher score in males than in females and significantly correlated with age. Because there have not been studies in the Mexican-mestizo community, we aimed to compare the differences in CXR scores between males and females and their correlation with age after controlling comorbidities like diabetes and hypertension. Materials and Methods A retrospective study of 1000 CXR of Mexican-mestizo patients with SARS-CoV-2 infection, confirmed by RT-PCR. Significant differences between age, age groups, symptoms, comorbidities, and CXR scores between males and females used the Mann–Whitney U, Chi-square tests (χ2), and Kruskal–Wallis tests. The relationship between the total CXR score and age was measured with the Spearman rank correlation coefficient (Rs); partial correlation analysis controlled the effect of symptoms, risk factors, and comorbidities. Results The total CXR score did not show a difference between males and females grouped by age. There was a positive, low correlation between the total CXR score and age in males, Rs = 0.260, p < 0.001 (N = 616), and in females, Rs = 0.170, p = 0.001 (N = 384). Age only explained a <9% variance of CXR severity. Rs decreased its magnitude (from Rs = 0.152 to Rs = 0.046) and lost its significance (change in p value from p < 0.001 to p = 0.145) after controlling the effect of hypertension. Conclusions There is no significant difference in CXR score between males and females in the Mexican-mestizo population grouped by age. Hypertension cancels the significance of CXR severity with age pointing to its role in the pathophysiology of COVID-19. Further research using stratified groups by age and gender in other populations needs to be published.
Highlights
Chest X-ray (CXR) is used for the initial triage of patients with suspected COVID-19
In 2015, a simple five-point grading chest X-ray (CXR) scoring system was proposed for nonradiologist clinicians to facilitate the clinical grading of CXR reports in hospitalised patients with an acute respiratory infection [8]; that scoring system was more focused on the severity of consolidation without grading the severity between interstitial and alveolar infiltrates
We performed a retrospective search on the department radiology information system (RIS)/picture archiving and communication system (PACS) between April and May of 2020 of chest X-ray (CXR) reports of only Mexican-mestizo patients admitted to the hospital with SARS-CoV-2 infection, confirmed by real-time reverse transcription-polymerase chain reaction laboratory testing
Summary
Chest X-ray (CXR) is used for the initial triage of patients with suspected COVID-19. There is no significant difference in CXR score between males and females in the Mexican-mestizo population grouped by age. European population a semiquantitative CXR scoring system for ranking the pulmonary involvement in hospitalised patients with COVID-19 based on an 18-point severity scale according to the extent and characteristics of lung abnormalities [7]. This score was based on the current knowledge of common chest CT findings in COVID-19 pneumonia (ground-glass opacity with or without patchy consolidation) [9, 10]. There was a difference in the scores between the age groups of each gender [11]
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