![]() Two investigators collected the clinical data regarding the time of onset of symptoms from the digital archive of the emergency department of all the patients suspected for COVID-19 admitted at Fondazione IRCCS Policlinico San Matteo between February 21 and March 8, 2020. The inclusion criteria of this retrospective study were as follows: (1) patients with confirmed SARS-CoV-2 infection, in which the SARS-CoV-2 infection was confirmed by real-time RT-PCR on nasopharyngeal swab or bronchoalveolar lavage (BAL) specimens, according to international guidelines (2) knowledge of the precise date of onset of symptoms considered linked to the onset of viral pneumonia such as fever (> 37.5 ☌), cough, and dyspnea and asymptomatic patients were excluded from the study and (3) patients who underwent CXR examination.Īll patients underwent CXR and RT-PCR on the day of admission in the emergency department. Our study aimed to evaluate the percentage of abnormal chest radiographs at different time intervals from the onset of symptoms and to identify the type and distribution of radiographic alterations and their frequency at different times throughout the disease course of COVID-19 pneumonia. In order to create reasonable imaging workflows, it is important to evaluate the diagnostic potential of CXR and that radiologists become familiar with the presentation pattern of COVID-19 in CXR. Also, the role of lung ultrasound is probably valuable but still unclear. Nonetheless, data specifically addressing CXR findings in COVID-19 are still limited. During the subsequent outbreak in the Western world, chest X-ray (CXR), together with arterial blood gas analysis and clinical presentation, in patients positive to RT-PCR, was recommended as a useful and easily available tool to support the initial diagnosis and for the subsequent management of COVID-19 patients. ![]() These studies analyzed and described the chest computed tomography (CT) findings at the presentation and at different times throughout the disease course. Several early radiological studies emphasized the role of radiological imaging in the early detection and management of COVID-19. The role of imaging in the diagnosis of COVID-19 is still under debate. According to the WHO, several molecular assays based on reverse transcription polymerase chain reaction (RT-PCR) for the individuation of SARS-CoV-2 genes are recommended for the confirmation of COVID-19. The manifestations of SARS-CoV-2 infection in humans range from mild respiratory symptoms to severe acute respiratory syndrome. Since December 2019, when the first cluster of cases of coronavirus disease 2019 (COVID-19) was reported in Wuhan, Hubei Province, China, the widespread transmission of coronavirus type 2 (SARS-CoV-2) has reached pandemic proportions. Consolidation was significantly less frequent ( p 9 days from the onset of symptoms. ResultsĪmong 240 patients who underwent CXR, 180 (75%) showed alterations (group A, 63.3% group B, 72% group C, 81.2% group D, 83.9%). Statistical significance was tested using chi-square test. ![]() Alteration’s type (reticular/ground-glass opacity (GGO)/consolidation) and distribution (bilateral/unilateral, upper/middle/lower fields, peripheral/central) were noted. ![]() Patients were clustered in four groups based on the number of days between symptom onset and CXR: group A (0–2 days), 49 patients group B (3–5), 75 patients group C (6–9), 85 patients and group D (> 9), 31 patients. Materials and methodsĬXR of 240 symptomatic patients (70% male, mean age 65 ± 16 years), with SARS-CoV-2 infection confirmed by RT-PCR, was retrospectively evaluated. ![]() To analyze the most frequent radiographic features of COVID-19 pneumonia and assess the effectiveness of chest X-ray (CXR) in detecting pulmonary alterations. ![]()
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