Chest X-ray findings normal for many confirmed COVID-19 cases

Most patients presenting to urgent care centers with confirmed coronavirus disease 2019 (COVID-19) have normal or mildly abnormal findings on chest X-rays (CXRs), according to a study published online April 14 in the Journal of Urgent Care Medicine.

20 april 2020--Michael B. Weinstock, M.D., from the Wexner Medical Center at The Ohio State University in Columbus, and colleagues examined the percentage of normal versus abnormal CXRs in urgent care patients with confirmed COVID-19 and described specific imaging characteristics of abnormal findings on CXR using a database of a large urgent care company in the greater New York City area. A total of 636 CXRs were reviewed among patients with confirmed COVID-19.

The researchers found that although patients were symptomatic enough to warrant imaging, 58.3 percent of the CXRs were normal. Of the 265 abnormal cases, 195, 65, and five demonstrated mild, moderate, and severe disease, respectively. The predominant descriptive findings were interstitial changes and ground glass opacities in 23.7 and 18.9 percent, respectively, of the total number of patients. Locations of the abnormalities were in the lower lobe, bilateral, and multifocal in 33.8, 20.9, and 24.2 percent, respectively. Effusions and lymphadenopathy were infrequently observed.

"In future reports we hope to examine what clinical signs, medical history, and demographic characteristics are associated with normal and abnormal CXR readings in patients with COVID-19," the authors write.

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More information: Abstract/Full Text