Chest radiographs may assist in predicting the outcome in the early phase of Covid-19. UK district general hospital experience of Covid-19 first wave

Berrill, Max; Karaj, Jola; Zamfir, Georgiana; Colman, Jordan; Mason, Rachel; Akbar, Saeed; Sharma, Shashank; Sheehan, Frances; Dhamija, Kanchan; Saltissi, Felicity; Baltabaeva, Aigul; Saikia, Sujoy

Objectives: Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has caused enormous strain on health-care systems worldwide. Early recognition of prognostic markers and appropriate management of patients with coronavirus disease 2019 (Covid-19) remains a major global health concern, particularly when resources are limited. We undertook a study to see if basic tests can inform frontline clinicians of disease trajectory in individual patients with COVID-19. Methods: We retrospectively assessed characteristics of the first 50 consecutive patients admitted to district general hospital in the United Kingdom with positive SARS-Cov-2 RNA swabs. Results: Our patient cohort shared broad similarities with previously published data on comorbidities and presenting features. We have found that chest radiographic assessment differed between survivors and non-survivors. Air space shadowing in middle zones were more prevalent in non-survivors (73.3% vs. 35.5% [p = 0.027]). Chest radiograph severity score was also found to be higher in non-survivors compared to survivors (3 vs. 1.5 [p = 0.007]). Conclusions: In this small retrospective study, our results suggest features of chest radiographs at presentation may provide a helpful tool for prognostication. In environments with constrained computed tomography (CT) imaging with serial chest radiographs could be a cost-effective tool in the assessment of Covid-19 patients.