Chest x-ray findings and temporal lung changes in patients with COVID-19 pneumonia

• Published in: BMC pulmonary medicine Vol. 20; no. 1; pp. 245 - 9
• Main Authors: Rousan, Liqa A., Elobeid, Eyhab, Karrar, Musaab, Khader, Yousef
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.09.2020; BioMed Central; BMC
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Asymptomatic; Chest; Chest x-rays; Child; Child, Preschool; Computed tomography; Consolidation; Coronavirus Infections - diagnostic imaging; Coronaviruses; COVID-19; Demography; Diagnosis; Female; Humans; Illnesses; Lung; Lung - diagnostic imaging; Male; Medical imaging; Middle Aged; Pandemics; Patients; Physiological aspects; Pleural effusion; Pneumonia; Pneumonia, Viral - diagnostic imaging; Polymerase chain reaction; Pulmonology; Radiography, Thoracic; Respiratory diseases; Retrospective Studies; Reverse transcription; Severe acute respiratory syndrome coronavirus 2; Time Factors; Tomography, X-Ray Computed; X-rays; Young Adult; Jordan; China
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-020-01286-5

Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients. From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients' demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients' symptoms. A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19. Their age ranged from 3 to 80 years (35.2 ± 18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6-11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12-17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6-11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P = 0.005). Almost half of patients with COVID-19 have abnormal chest x-ray findings with peripheral GGO affecting the lower lobes being the most common finding. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.