Late Breaking Abstract - Chest radiography-a predictor of prognosis in COVID-19

Abstract

<b>Introduction:</b> Chest radiography (CXR) is typically the first-line imaging modality used for patients with suspected COVID-19. CXRs may be normal in early or mild disease. Of patients with COVID-19 requiring hospitalization, 69% had an abnormal CXR at the initial time of admission, and 80% had radiographic abnormalities sometime during hospitalization (Wong et al. 2020). We aimed to investigate CXR findings at admission and its predictive value of outcomes in these patients. <b>Methods:</b> 595 patients were admitted with symptoms suggestive of COVID-19 between 15/3/2020-30/4/2020. Data were retrospectively analysed to ascertain the rate of CXR abnormality suggestive of COVID-19 at admission and the correlation with ITU admission, Continuous Positive Airway pressure (CPAP) use, Reverse Transcription-Polymerase Chain Reaction (RT-PCR) swab positivity, and mortality. <b>Results:</b> Normal CXR as a negative predictor for ITU admission, CPAP use, mortality, and RT-PCR positivity were all statistically significant (P&lt;0.05). All patients with a normal CXR who died were not for ITU treatment, thus co-morbidities and frailty may have been significant contributory factors. <b>Conclusion:</b> In those hospitalised with COVID-19, a normal CXR on arrival serves as a particularly good predictor of an uncomplicated admission (without the need for CPAP or ITU); and is associated with significantly reduced risk of mortality.