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.
Identifieur interne : 000127 ( Main/Corpus ); précédent : 000126; suivant : 000128Severity 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.
Auteurs : Elisa Baratella ; Paola Crivelli ; Cristina Marrocchio ; Alessandro Marco Bozzato ; Andrea De Vito ; Giordano Madeddu ; Laura Saderi ; Marco Confalonieri ; Luigi Tenaglia ; Maria Assunta CovaSource :
- Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia [ 1806-3756 ] ; 2020.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Betacoronavirus (MeSH), Coronavirus Infections (diagnostic imaging), Coronavirus Infections (epidemiology), Female (MeSH), Humans (MeSH), Italy (epidemiology), Lung (diagnostic imaging), Lung (physiopathology), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (diagnostic imaging), Pneumonia, Viral (epidemiology), Radiography, Thoracic (methods), Retrospective Studies (MeSH), Severe Acute Respiratory Syndrome (MeSH), X-Rays (MeSH).
- MESH :
- geographic , epidemiology : Italy.
- diagnostic imaging : Coronavirus Infections, Lung, Pneumonia, Viral.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- methods : Radiography, Thoracic.
- physiopathology : Lung.
- Adult, Aged, Aged, 80 and over, Betacoronavirus, Female, Humans, Male, Middle Aged, Pandemics, Retrospective Studies, Severe Acute Respiratory Syndrome, X-Rays.
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).
DOI: 10.36416/1806-3756/e20200226
PubMed: 32965310
Links to Exploration step
pubmed:32965310Le document en format XML
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<author><name sortKey="Baratella, Elisa" sort="Baratella, Elisa" uniqKey="Baratella E" first="Elisa" last="Baratella">Elisa Baratella</name>
<affiliation><nlm:affiliation>. Dipartimento di Radiologia, Università degli Studi di Trieste, Trieste, Italia.</nlm:affiliation>
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<author><name sortKey="Crivelli, Paola" sort="Crivelli, Paola" uniqKey="Crivelli P" first="Paola" last="Crivelli">Paola Crivelli</name>
<affiliation><nlm:affiliation>. Diagnostica per immagini 2, AOU Sassari, Sassari, Italia.</nlm:affiliation>
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<author><name sortKey="Marrocchio, Cristina" sort="Marrocchio, Cristina" uniqKey="Marrocchio C" first="Cristina" last="Marrocchio">Cristina Marrocchio</name>
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<author><name sortKey="Bozzato, Alessandro Marco" sort="Bozzato, Alessandro Marco" uniqKey="Bozzato A" first="Alessandro Marco" last="Bozzato">Alessandro Marco Bozzato</name>
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<author><name sortKey="Vito, Andrea De" sort="Vito, Andrea De" uniqKey="Vito A" first="Andrea De" last="Vito">Andrea De Vito</name>
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<author><name sortKey="Madeddu, Giordano" sort="Madeddu, Giordano" uniqKey="Madeddu G" first="Giordano" last="Madeddu">Giordano Madeddu</name>
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<author><name sortKey="Saderi, Laura" sort="Saderi, Laura" uniqKey="Saderi L" first="Laura" last="Saderi">Laura Saderi</name>
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<author><name sortKey="Confalonieri, Marco" sort="Confalonieri, Marco" uniqKey="Confalonieri M" first="Marco" last="Confalonieri">Marco Confalonieri</name>
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<author><name sortKey="Tenaglia, Luigi" sort="Tenaglia, Luigi" uniqKey="Tenaglia L" first="Luigi" last="Tenaglia">Luigi Tenaglia</name>
<affiliation><nlm:affiliation>. Dipartimento ad Attività Integrata di Emergenza, Urgenza ed Accettazione, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italia.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Cova, Maria Assunta" sort="Cova, Maria Assunta" uniqKey="Cova M" first="Maria Assunta" last="Cova">Maria Assunta Cova</name>
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<author><name sortKey="Baratella, Elisa" sort="Baratella, Elisa" uniqKey="Baratella E" first="Elisa" last="Baratella">Elisa Baratella</name>
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<author><name sortKey="Crivelli, Paola" sort="Crivelli, Paola" uniqKey="Crivelli P" first="Paola" last="Crivelli">Paola Crivelli</name>
<affiliation><nlm:affiliation>. Diagnostica per immagini 2, AOU Sassari, Sassari, Italia.</nlm:affiliation>
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<author><name sortKey="Marrocchio, Cristina" sort="Marrocchio, Cristina" uniqKey="Marrocchio C" first="Cristina" last="Marrocchio">Cristina Marrocchio</name>
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<author><name sortKey="Vito, Andrea De" sort="Vito, Andrea De" uniqKey="Vito A" first="Andrea De" last="Vito">Andrea De Vito</name>
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<author><name sortKey="Madeddu, Giordano" sort="Madeddu, Giordano" uniqKey="Madeddu G" first="Giordano" last="Madeddu">Giordano Madeddu</name>
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<author><name sortKey="Saderi, Laura" sort="Saderi, Laura" uniqKey="Saderi L" first="Laura" last="Saderi">Laura Saderi</name>
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<author><name sortKey="Tenaglia, Luigi" sort="Tenaglia, Luigi" uniqKey="Tenaglia L" first="Luigi" last="Tenaglia">Luigi Tenaglia</name>
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</affiliation>
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<author><name sortKey="Cova, Maria Assunta" sort="Cova, Maria Assunta" uniqKey="Cova M" first="Maria Assunta" last="Cova">Maria Assunta Cova</name>
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<term>Coronavirus Infections (diagnostic imaging)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Italy (epidemiology)</term>
<term>Lung (diagnostic imaging)</term>
<term>Lung (physiopathology)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (diagnostic imaging)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>Radiography, Thoracic (methods)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Severe Acute Respiratory Syndrome (MeSH)</term>
<term>X-Rays (MeSH)</term>
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<term>Lung</term>
<term>Pneumonia, Viral</term>
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<term>Pneumonia, Viral</term>
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<term>Male</term>
<term>Middle Aged</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>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.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>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.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>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.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>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).</p>
</div>
</front>
</TEI>
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<DateCompleted><Year>2020</Year>
<Month>09</Month>
<Day>28</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>09</Month>
<Day>28</Day>
</DateRevised>
<Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1806-3756</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>46</Volume>
<Issue>5</Issue>
<PubDate><Year>2020</Year>
</PubDate>
</JournalIssue>
<Title>Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia</Title>
<ISOAbbreviation>J Bras Pneumol</ISOAbbreviation>
</Journal>
<ArticleTitle>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.</ArticleTitle>
<Pagination><MedlinePgn>e20200226</MedlinePgn>
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<Abstract><AbstractText Label="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.</AbstractText>
<AbstractText Label="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.</AbstractText>
<AbstractText Label="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.</AbstractText>
<AbstractText Label="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).</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Baratella</LastName>
<ForeName>Elisa</ForeName>
<Initials>E</Initials>
<Identifier Source="ORCID">0000-0002-1061-9507</Identifier>
<AffiliationInfo><Affiliation>. Dipartimento di Radiologia, Università degli Studi di Trieste, Trieste, Italia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Crivelli</LastName>
<ForeName>Paola</ForeName>
<Initials>P</Initials>
<Identifier Source="ORCID">0000-0002-4324-7439</Identifier>
<AffiliationInfo><Affiliation>. Diagnostica per immagini 2, AOU Sassari, Sassari, Italia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Marrocchio</LastName>
<ForeName>Cristina</ForeName>
<Initials>C</Initials>
<Identifier Source="ORCID">0000-0003-2757-7400</Identifier>
<AffiliationInfo><Affiliation>. Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Università degli Studi di Trieste, Trieste, Italia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bozzato</LastName>
<ForeName>Alessandro Marco</ForeName>
<Initials>AM</Initials>
<Identifier Source="ORCID">0000-0002-7344-3668</Identifier>
<AffiliationInfo><Affiliation>. Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Università degli Studi di Trieste, Trieste, Italia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Vito</LastName>
<ForeName>Andrea De</ForeName>
<Initials>A</Initials>
<Identifier Source="ORCID">0000-0002-8265-5400</Identifier>
<AffiliationInfo><Affiliation>. Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Università degli Studi di Sassari, Sassari, Italia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Madeddu</LastName>
<ForeName>Giordano</ForeName>
<Initials>G</Initials>
<Identifier Source="ORCID">0000-0001-6099-2273</Identifier>
<AffiliationInfo><Affiliation>. Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, Università degli Studi di Sassari, Sassari, Italia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Saderi</LastName>
<ForeName>Laura</ForeName>
<Initials>L</Initials>
<Identifier Source="ORCID">0000-0002-5131-9367</Identifier>
<AffiliationInfo><Affiliation>. Unità di Epidemiologia Clinica e Statistica Medica, Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università degli Studi di Sassari, Sassari, Italia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Confalonieri</LastName>
<ForeName>Marco</ForeName>
<Initials>M</Initials>
<Identifier Source="ORCID">0000-0002-4791-768X</Identifier>
<AffiliationInfo><Affiliation>. Dipartimento di Pneumologia, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tenaglia</LastName>
<ForeName>Luigi</ForeName>
<Initials>L</Initials>
<Identifier Source="ORCID">0000-0001-5169-3984</Identifier>
<AffiliationInfo><Affiliation>. Dipartimento ad Attività Integrata di Emergenza, Urgenza ed Accettazione, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cova</LastName>
<ForeName>Maria Assunta</ForeName>
<Initials>MA</Initials>
<Identifier Source="ORCID">0000-0002-8411-1001</Identifier>
<AffiliationInfo><Affiliation>. Dipartimento di Radiologia, Università degli Studi di Trieste, Trieste, Italia.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<Language>por</Language>
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<Month>09</Month>
<Day>21</Day>
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<MedlineTA>J Bras Pneumol</MedlineTA>
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<ISSNLinking>1806-3713</ISSNLinking>
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<SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
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<MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName>
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<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
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<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
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<MeshHeading><DescriptorName UI="D007558" MajorTopicYN="N" Type="Geographic">Italy</DescriptorName>
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<MeshHeading><DescriptorName UI="D008168" MajorTopicYN="N">Lung</DescriptorName>
<QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName>
<QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName>
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<QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
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<MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D045169" MajorTopicYN="N">Severe Acute Respiratory Syndrome</DescriptorName>
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