High-risk chest radiographic features associated with COVID-19 disease severity.
<h4>Objectives</h4>High-risk CXR features in COVID-19 are not clearly defined. We aimed to identify CXR features that correlate with severe COVID-19.<h4>Methods</h4>All confirmed COVID-19 patients admitted within the study period were screened. Those with suboptimal baseline...
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0245518&type=printable |
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| author | Sean Wei Xiang Ong Terrence Chi Hong Hui Yeong Shyan Lee Salahudeen Mohamed Haja Mohideen Barnaby Edward Young Cher Heng Tan David Chien Lye |
| author_facet | Sean Wei Xiang Ong Terrence Chi Hong Hui Yeong Shyan Lee Salahudeen Mohamed Haja Mohideen Barnaby Edward Young Cher Heng Tan David Chien Lye |
| author_sort | Sean Wei Xiang Ong |
| collection | DOAJ |
| description | <h4>Objectives</h4>High-risk CXR features in COVID-19 are not clearly defined. We aimed to identify CXR features that correlate with severe COVID-19.<h4>Methods</h4>All confirmed COVID-19 patients admitted within the study period were screened. Those with suboptimal baseline CXR were excluded. CXRs were reviewed by three independent radiologists and opacities recorded according to zones and laterality. The primary endpoint was defined as hypoxia requiring supplemental oxygen, and CXR features were assessed for association with this endpoint to identify high-risk features. These features were then used to define criteria for a high-risk CXR, and clinical features and outcomes of patients with and without baseline high-risk CXR were compared using logistic regression analysis.<h4>Results</h4>109 patients were included. In the initial analysis of 40 patients (36.7%) with abnormal baseline CXR, presence of bilateral opacities, multifocal opacities, or any upper or middle zone opacity were associated with supplemental oxygen requirement. Of the entire cohort, 29 patients (26.6%) had a baseline CXR with at least one of these features. Having a high-risk baseline CXR was significantly associated with requiring supplemental oxygen in univariate (odds ratio 14.0, 95% confidence interval 3.90-55.60) and multivariate (adjusted odds ratio 8.38, 95% CI 2.43-28.97, P = 0.001) analyses.<h4>Conclusion</h4>We identified several high-risk CXR features that are significantly associated with severe illness. The association of upper or middle zone opacities with severe illness has not been previously emphasized. Recognition of these specific high-risk CXR features is important to prioritize limited healthcare resources for sicker patients. |
| format | Article |
| id | doaj-art-83dc4f4695b84d1db9b5f6e8f39e83c1 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-83dc4f4695b84d1db9b5f6e8f39e83c12025-08-20T02:55:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01161e024551810.1371/journal.pone.0245518High-risk chest radiographic features associated with COVID-19 disease severity.Sean Wei Xiang OngTerrence Chi Hong HuiYeong Shyan LeeSalahudeen Mohamed Haja MohideenBarnaby Edward YoungCher Heng TanDavid Chien Lye<h4>Objectives</h4>High-risk CXR features in COVID-19 are not clearly defined. We aimed to identify CXR features that correlate with severe COVID-19.<h4>Methods</h4>All confirmed COVID-19 patients admitted within the study period were screened. Those with suboptimal baseline CXR were excluded. CXRs were reviewed by three independent radiologists and opacities recorded according to zones and laterality. The primary endpoint was defined as hypoxia requiring supplemental oxygen, and CXR features were assessed for association with this endpoint to identify high-risk features. These features were then used to define criteria for a high-risk CXR, and clinical features and outcomes of patients with and without baseline high-risk CXR were compared using logistic regression analysis.<h4>Results</h4>109 patients were included. In the initial analysis of 40 patients (36.7%) with abnormal baseline CXR, presence of bilateral opacities, multifocal opacities, or any upper or middle zone opacity were associated with supplemental oxygen requirement. Of the entire cohort, 29 patients (26.6%) had a baseline CXR with at least one of these features. Having a high-risk baseline CXR was significantly associated with requiring supplemental oxygen in univariate (odds ratio 14.0, 95% confidence interval 3.90-55.60) and multivariate (adjusted odds ratio 8.38, 95% CI 2.43-28.97, P = 0.001) analyses.<h4>Conclusion</h4>We identified several high-risk CXR features that are significantly associated with severe illness. The association of upper or middle zone opacities with severe illness has not been previously emphasized. Recognition of these specific high-risk CXR features is important to prioritize limited healthcare resources for sicker patients.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0245518&type=printable |
| spellingShingle | Sean Wei Xiang Ong Terrence Chi Hong Hui Yeong Shyan Lee Salahudeen Mohamed Haja Mohideen Barnaby Edward Young Cher Heng Tan David Chien Lye High-risk chest radiographic features associated with COVID-19 disease severity. PLoS ONE |
| title | High-risk chest radiographic features associated with COVID-19 disease severity. |
| title_full | High-risk chest radiographic features associated with COVID-19 disease severity. |
| title_fullStr | High-risk chest radiographic features associated with COVID-19 disease severity. |
| title_full_unstemmed | High-risk chest radiographic features associated with COVID-19 disease severity. |
| title_short | High-risk chest radiographic features associated with COVID-19 disease severity. |
| title_sort | high risk chest radiographic features associated with covid 19 disease severity |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0245518&type=printable |
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