Covid-19 Xray findings

Covid x ray findings

1. Chest Xray findings in COVID -19 DEV LAkhera

2. For COVID-19 pneumonia few early studies which have been done show radiologic similarities to SARS and MERS pneumonia Predominance of bilateral GGO and consolidative lesions in the peripheral lung Despite the similarities in CT findings, COVID-19 pneumonia seems radiologically milder than SARS and MERS pneumonia. The proportion of patients with abnormal initial radiographic findings was 78.3–82.4% in SARS and 83.6% in MERS, but only 33% in cases of COVID-19 pneumonia (*KJR Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients Treated in Korea ).

3. In a cohort of 64 patients ** with COVID-19 infection and imaging follow-up, baseline chest x-ray had a sensitivity of 69%, compared to 91% for initial RT-PCR. **Frequency and Distribution of Chest Radiographic Findings in COVID-19 Positive Patients. Radiology Mar 27 2020

4. Chest Radiographic Findings Laterally: Equally involves both lung fields Cephalocaudal distribution: Lower > middle > upper Central to peripheral distribution: Peripheral >> central / central and peripheral Shape of opacity: Patchy >>> Nodular Density: Consolidation > Ground glass lesions Pleural effusion Highly uncommon (3%)

5. Case 1: COVID -19 confirmed patient Anteroposterior chest radiograph shows multifocal patchy peripheral consolidations in bilateral lungs, except for left upper lung zone

6. Representative CT in same patient

7. Peripheral distribution of opacity Perihilar distribution of opacity

8. Evolution of disease in a COVID positive patient over 7 days Day 1 Day 4 Normal Patchy, ill-defined bilateral alveolar consolidations, with a peripheral distribution

9. Day 7 Radiological worsening, with typical findings of acute respiratory distress syndrome (ARDS).

10. Atypical presentation :Case II confirmed covid Anteroposterior chest radiograph shows single nodular consolidation (arrows) in left lower lung zone.

11. Conclusion Chest X-ray has low sensitivity for COVID-19. Chest X-ray can be normal in large number of patients. Typical findings include - Patchy consolidating opacities in peripheral and lower lobar distribution . References KJR Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients Treated in Korea Frequency and Distribution of Chest Radiographic Findings in COVID-19 Positive Patients. Radiology Mar 27 2020

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