Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: an observational retrospective analysis of the relationship between radiological, clinical, and laboratory data
ABSTRACT Objective: To investigate the diagnostic accuracy of a chest X-ray (CXR) score and of clinical and laboratory data in predicting the clinical course of patients with SARS coronavirus 2 (SARS-CoV-2) infection. Methods: This is a pilot multicenter retrospective study including patients with...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Pneumologia e Tisiologia
2020-09-01
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| Series: | Jornal Brasileiro de Pneumologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132020000500206&tlng=en |
| _version_ | 1798015374101315584 |
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| author | Elisa Baratella Paola Crivelli Cristina Marrocchio Alessandro Marco Bozzato Andrea De Vito Giordano Madeddu Laura Saderi Marco Confalonieri Luigi Tenaglia Maria Assunta Cova |
| author_facet | Elisa Baratella Paola Crivelli Cristina Marrocchio Alessandro Marco Bozzato Andrea De Vito Giordano Madeddu Laura Saderi Marco Confalonieri Luigi Tenaglia Maria Assunta Cova |
| author_sort | Elisa Baratella |
| collection | DOAJ |
| description | ABSTRACT Objective: To investigate the diagnostic accuracy of a chest X-ray (CXR) score and of clinical and laboratory data in predicting the clinical course of patients with SARS coronavirus 2 (SARS-CoV-2) infection. Methods: This is a pilot multicenter retrospective study including patients with SARS-CoV-2 infection admitted to the ERs in three hospitals in Italy between February and March of 2020. Two radiologists independently evaluated the baseline CXR of the patients using a semi-quantitative score to determine the severity of lung involvement: a score of 0 represented no lung involvement, whereas scores of 1 to 4 represented the first (less severe) to the fourth (more severe) quartiles regarding the severity of lung involvement. Relevant clinical and laboratory data were collected. The outcome of patients was defined as severe if noninvasive ventilation (NIV) or intubation was necessary, or if the patient died. Results: Our sample comprised 140 patients. Most of the patients were symptomatic (132/138; 95.7%), and 133/140 patients (95.0%) presented with opacities on CXR at admission. Of the 140 patients, 7 (5.0%) showed no lung involvement, whereas 58 (41.4%), 31 (22.1%), 26 (18.6%), and 18 (12.9%), respectively, scored 1, 2, 3, and 4. In our sample, 66 patients underwent NIV or intubation, 37 of whom scored 1 or 2 on baseline CXR, and 28 patients died. Conclusions: The severity score based on CXR seems to be able to predict the clinical progression in cases that scored 0, 3, or 4. However, the score alone cannot predict the clinical progression in patients with mild-to-moderate parenchymal involvement (scores 1 and 2). |
| first_indexed | 2024-04-11T15:33:22Z |
| format | Article |
| id | doaj.art-4a7691e4e3d044d88936579492d87baf |
| institution | Directory Open Access Journal |
| issn | 1806-3756 |
| language | English |
| last_indexed | 2024-04-11T15:33:22Z |
| publishDate | 2020-09-01 |
| publisher | Sociedade Brasileira de Pneumologia e Tisiologia |
| record_format | Article |
| series | Jornal Brasileiro de Pneumologia |
| spelling | doaj.art-4a7691e4e3d044d88936579492d87baf2022-12-22T04:16:05ZengSociedade Brasileira de Pneumologia e TisiologiaJornal Brasileiro de Pneumologia1806-37562020-09-0146510.36416/1806-3756/e20200226Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: an observational retrospective analysis of the relationship between radiological, clinical, and laboratory dataElisa Baratellahttps://orcid.org/0000-0002-1061-9507Paola Crivellihttps://orcid.org/0000-0002-4324-7439Cristina Marrocchiohttps://orcid.org/0000-0003-2757-7400Alessandro Marco Bozzatohttps://orcid.org/0000-0002-7344-3668Andrea De Vitohttps://orcid.org/0000-0002-8265-5400Giordano Madedduhttps://orcid.org/0000-0001-6099-2273Laura Saderihttps://orcid.org/0000-0002-5131-9367Marco Confalonierihttps://orcid.org/0000-0002-4791-768XLuigi Tenagliahttps://orcid.org/0000-0001-5169-3984Maria Assunta Covahttps://orcid.org/0000-0002-8411-1001ABSTRACT Objective: To investigate the diagnostic accuracy of a chest X-ray (CXR) score and of clinical and laboratory data in predicting the clinical course of patients with SARS coronavirus 2 (SARS-CoV-2) infection. Methods: This is a pilot multicenter retrospective study including patients with SARS-CoV-2 infection admitted to the ERs in three hospitals in Italy between February and March of 2020. Two radiologists independently evaluated the baseline CXR of the patients using a semi-quantitative score to determine the severity of lung involvement: a score of 0 represented no lung involvement, whereas scores of 1 to 4 represented the first (less severe) to the fourth (more severe) quartiles regarding the severity of lung involvement. Relevant clinical and laboratory data were collected. The outcome of patients was defined as severe if noninvasive ventilation (NIV) or intubation was necessary, or if the patient died. Results: Our sample comprised 140 patients. Most of the patients were symptomatic (132/138; 95.7%), and 133/140 patients (95.0%) presented with opacities on CXR at admission. Of the 140 patients, 7 (5.0%) showed no lung involvement, whereas 58 (41.4%), 31 (22.1%), 26 (18.6%), and 18 (12.9%), respectively, scored 1, 2, 3, and 4. In our sample, 66 patients underwent NIV or intubation, 37 of whom scored 1 or 2 on baseline CXR, and 28 patients died. Conclusions: The severity score based on CXR seems to be able to predict the clinical progression in cases that scored 0, 3, or 4. However, the score alone cannot predict the clinical progression in patients with mild-to-moderate parenchymal involvement (scores 1 and 2).http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132020000500206&tlng=enCoronavirus infectionsRadiography, thoracicPneumoniaRespiratory insufficiencySevere acute respiratory syndrome |
| spellingShingle | Elisa Baratella Paola Crivelli Cristina Marrocchio Alessandro Marco Bozzato Andrea De Vito Giordano Madeddu Laura Saderi Marco Confalonieri Luigi Tenaglia Maria Assunta Cova Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: an observational retrospective analysis of the relationship between radiological, clinical, and laboratory data Jornal Brasileiro de Pneumologia Coronavirus infections Radiography, thoracic Pneumonia Respiratory insufficiency Severe acute respiratory syndrome |
| title | Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: an observational retrospective analysis of the relationship between radiological, clinical, and laboratory data |
| title_full | Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: an observational retrospective analysis of the relationship between radiological, clinical, and laboratory data |
| title_fullStr | Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: an observational retrospective analysis of the relationship between radiological, clinical, and laboratory data |
| title_full_unstemmed | Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: an observational retrospective analysis of the relationship between radiological, clinical, and laboratory data |
| title_short | Severity of lung involvement on chest X-rays in SARS-coronavirus-2 infected patients as a possible tool to predict clinical progression: an observational retrospective analysis of the relationship between radiological, clinical, and laboratory data |
| title_sort | severity of lung involvement on chest x rays in sars coronavirus 2 infected patients as a possible tool to predict clinical progression an observational retrospective analysis of the relationship between radiological clinical and laboratory data |
| topic | Coronavirus infections Radiography, thoracic Pneumonia Respiratory insufficiency Severe acute respiratory syndrome |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132020000500206&tlng=en |
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