Purpose: To evaluate the diagnostic accuracy and the imaging features of routine admission chest X-ray in patients suspected for novel Coronavirus 2019 (SARS-CoV-2) infection. Method: We retrospectively evaluated clinical and X-ray features in all patients referred to the emergency department for suspected SARS-CoV-2 infection between March 1st and March 13th. A single radiologist with more than 15 years of experience in chest-imaging evaluated the presence and extent of alveolar opacities, reticulations, and/or pleural effusion. The percentage of lung involvement (range <25 % to 75–100 %) was also calculated. We stratified patients in groups according to the time interval between symptoms onset and X-ray imaging (≤ 5 and > 5 days) and according to age (≤ 50 and > 50 years old). Results: A total of 518 patients were enrolled. Overall 314 patients had negative and 204 had positive RT-PCR results. Lung lesions in patients with SARS-Cov2 pneumonia primarily manifested as alveolar and interstitial opacities and were mainly bilateral (60.8 %). Lung abnormalities were more frequent and more severe by symptom duration and by increasing age. The sensitivity and specificity of chest X-ray at admission in the overall cohort were 57 % (95 % CI = 47–67) and 89 % (83–94), respectively. Sensitivity was higher for patients with symptom onset > 5 days compared to ≤ 5 days (76 % [62–87] vs 37 % [24–52]) and in patients > 50 years old compared to ≤ 50 years (59 % [48–69] vs 47 % [23–72]), at the expense of a slightly lower specificity (68 % [45–86] and 82 % [73–89], respectively). Conclusions: Overall chest X-ray sensitivity for SARS-CoV-2 pneumonia was 57 %. Sensitivity was higher when symptoms had started more than 5 days before, at the expense of lesser specificity, while slightly higher in older patients in comparison to younger ones.

Ippolito, D., Pecorelli, A., Maino, C., Capodaglio, C., Mariani, I., Giandola, T., et al. (2020). Diagnostic impact of bedside chest X-ray features of 2019 novel coronavirus in the routine admission at the emergency department: case series from Lombardy region. EUROPEAN JOURNAL OF RADIOLOGY, 129 [10.1016/j.ejrad.2020.109092].

Diagnostic impact of bedside chest X-ray features of 2019 novel coronavirus in the routine admission at the emergency department: case series from Lombardy region

Ippolito D.
;
Pecorelli A.;Maino C.;Mariani I.;Giandola T.;Gandola D.;Ragusi M.;Talei Franzesi C.;Sironi S.
2020

Abstract

Purpose: To evaluate the diagnostic accuracy and the imaging features of routine admission chest X-ray in patients suspected for novel Coronavirus 2019 (SARS-CoV-2) infection. Method: We retrospectively evaluated clinical and X-ray features in all patients referred to the emergency department for suspected SARS-CoV-2 infection between March 1st and March 13th. A single radiologist with more than 15 years of experience in chest-imaging evaluated the presence and extent of alveolar opacities, reticulations, and/or pleural effusion. The percentage of lung involvement (range <25 % to 75–100 %) was also calculated. We stratified patients in groups according to the time interval between symptoms onset and X-ray imaging (≤ 5 and > 5 days) and according to age (≤ 50 and > 50 years old). Results: A total of 518 patients were enrolled. Overall 314 patients had negative and 204 had positive RT-PCR results. Lung lesions in patients with SARS-Cov2 pneumonia primarily manifested as alveolar and interstitial opacities and were mainly bilateral (60.8 %). Lung abnormalities were more frequent and more severe by symptom duration and by increasing age. The sensitivity and specificity of chest X-ray at admission in the overall cohort were 57 % (95 % CI = 47–67) and 89 % (83–94), respectively. Sensitivity was higher for patients with symptom onset > 5 days compared to ≤ 5 days (76 % [62–87] vs 37 % [24–52]) and in patients > 50 years old compared to ≤ 50 years (59 % [48–69] vs 47 % [23–72]), at the expense of a slightly lower specificity (68 % [45–86] and 82 % [73–89], respectively). Conclusions: Overall chest X-ray sensitivity for SARS-CoV-2 pneumonia was 57 %. Sensitivity was higher when symptoms had started more than 5 days before, at the expense of lesser specificity, while slightly higher in older patients in comparison to younger ones.
Articolo in rivista - Articolo scientifico
Coronavirus; Infections; Radiography; Tomography; X-ray computed
English
26-mag-2020
2020
129
109092
none
Ippolito, D., Pecorelli, A., Maino, C., Capodaglio, C., Mariani, I., Giandola, T., et al. (2020). Diagnostic impact of bedside chest X-ray features of 2019 novel coronavirus in the routine admission at the emergency department: case series from Lombardy region. EUROPEAN JOURNAL OF RADIOLOGY, 129 [10.1016/j.ejrad.2020.109092].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/277878
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