Coronavirus Disease 2019 Outbreak: Use of a Chest X-Ray Scoring System and Evaluation of the Radiologic Findings

Abstract

BACKGOUND/AIMS Our objective was to identify the chest X-ray (CXR) features of the patients with coronavirus disease 2019 (COVID-19) and to evaluate the relationship between CXR scores and age and gender. Also, we aimed to detect the sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of CXRs in patients with COVID-19 pneumonia. MATERIAL and METHODS A total of 35 patients who underwent CXR and computed tomography (CT) and had a positive real-time reverse transcriptase-polymerase chain reaction test result were included in the study. The initial CXRs of all patients were evaluated and scored using the Brixia scoring system. Then, chest CT scans were assessed the presence of pneumonia. RESULTS Of the 35 patients, CXRs of 13 patients (6 male and 7 female) were normal, and 22 patients had unilateral or bilateral opacities, which was considered to indicate pneumonia. The sensitivity, PPV, NPV, and accuracy of the CXRs in the detection of pneumonia were 81.4%, 100%, 61.5%, and 85.7%, respectively. The median Brixia score of patients without pneumonia was less than that of the patients with pneumonia (4 [1-6] vs 7 [4-12]; P < .01). CONCLUSION This scoring system might be useful for identifying the highest-risk patients at an early stage and determine who requires early medical management in the pandemic service or intensive care unit.