Frequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19

Area of Science:

• Radiology
• Infectious Diseases
• Pulmonology

Background:

• Current COVID-19 literature heavily features CT scans, with limited data on chest radiography (CXR) findings over time.
• A detailed understanding of CXR appearances in relation to the COVID-19 disease timeline is needed.

Purpose of the Study:

• To describe the temporal evolution and severity of COVID-19 findings on chest radiography.
• To correlate these radiographic findings with SARS-CoV-2 nucleic acid RT-PCR test results.

Main Methods:

• Retrospective analysis of 255 chest radiographs from 64 COVID-19 patients confirmed by RT-PCR.
• Radiographs were scored for consolidation, ground-glass opacity, location, and pleural fluid, with a severity index calculated.
• Correlation with concurrent CT scans was performed where available.

Main Results:

• Initial RT-PCR sensitivity (91%) was higher than baseline chest radiography (69%).
• Consolidation (47%) and ground-glass opacities (33%) were the most common findings, often peripheral, in lower lung zones, and bilateral.
• Radiographic findings peaked in severity 10-12 days after symptom onset.

Conclusions:

• Chest radiography in COVID-19 commonly shows bilateral lower zone consolidation.
• The severity of radiographic findings peaks approximately 10-12 days from symptom onset.
• Radiographic and virologic recovery times were not significantly different.