Radiographic findings in 240 patients with COVID-19 pneumonia: time-dependence after the onset of symptoms

摘要

Objective To analyze the most frequent radiographic features of COVID-19 pneumonia and assess the effectiveness of chest X-ray (CXR) in detecting pulmonary alterations. Materials and methods CXR of 240 symptomatic patients (70 male, mean age 65 +/- 16 years), with SARS-CoV-2 infection confirmed by RT-PCR, was retrospectively evaluated. Patients were clustered in four groups based on the number of days between symptom onset and CXR: group A (0-2 days), 49 patients; group B (3-5), 75 patients; group C (6-9), 85 patients; and group D (> 9), 31 patients. Alteration's type (reticular/ground-glass opacity (GGO)/consolidation) and distribution (bilateral/unilateral, upper/middle/lower fields, peripheral/central) were noted. Statistical significance was tested using chi-square test. Results Among 240 patients who underwent CXR, 180 (75) showed alterations (group A, 63.3; group B, 72; group C, 81.2; group D, 83.9). GGO was observed in 124/180 patients (68.8), reticular alteration in 113/180 (62.7), and consolidation in 71/180 (39.4). Consolidation was significantly less frequent (p < 0.01). Distribution among groups was as follows: reticular alteration (group A, 70.9; group B, 72.2; group C, 57.9; group D, 46.1), GGO (group A, 67.7; group B, 62.9; group C, 71; group D, 76.9), and consolidation (group A, 35.5; group B, 31.4; group C, 47.8; group D, 38.5). Alterations were bilateral in 73.3. Upper, middle, and lower fields were involved in 36.7, 79.4, and 87.8, respectively. Lesions were peripheral in 49.4, central in 11.1, or both in 39.4. Upper fields and central zones were significantly less involved (p < 0.01). Conclusions The most frequent lesions in COVID-19 patients were GGO (intermediate/late phase) and reticular alteration (early phase) while consolidation gradually increased over time. The most frequent distribution was bilateral, peripheral, and with middle/lower predominance. Overall rate of negative CXR was 25, which progressively decreased over time.