The Relationship of Chest X-Ray in COVID-19 Patients and Disease Severity in Arifin Achmad General Hospital Riau
Introduction: Coronavirus Disease 2019 (COVID-19) pandemic is caused by SARS-CoV-2 which spreads rapidly throughout the world and causes clinical manifestations in various organs, especially in the lungs. Clinical symptoms arise from asymptomatic, mild, moderate, severe, and critical symptoms in patients with or without comorbid disease. Chest X-ray examination is one of the modalities in the management of COVID-19 which is cheap and easy to do.
Methods: This study was performed by analyzing medical record data of confirmed COVID-19 patients from March to December 2020. This study aimed to examine the relationship between chest X-ray and the degree of disease severity.
Results: The results showed that from the examined 542 total samples, the highest number was found in the age group of 40-49 years old (23.6%), women (53%), mild degree of COVID-19 (67.9%), normal chest X-ray (54.6%), predominance on the lower zone of the lung, peripheral and bilateral on abnormal chest X-ray, no comorbid (56.3%), hypertensive in comorbid disease (26.6%). There was a significant relationship between chest X-ray and comorbidity towards COVID-19 severity (p = 0.000).Conclusion:Chest X-ray can determine disease severity, therefore it can be used as the first modality for triage and treatment evaluation in COVID-19 patients.
Bogoch II, Watts A, Thomas-Bachli A, Huber C, Kraemer MUG, Khan K, et al. Pneumonia of Unknown Aetiology in Wuhan, China: Potential for International Spread Via Commercial Air Travel. J Travel Med. 2020;27(2):1-3.
World Health Organization. Pneumonia of Unknown Cause – China. https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause- china/en/. Diakses 13 Desember 2020.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical Features of Patients Infected with 2019 Novel Coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical Characteristics of 99 Cases of 2019 Novel Coronavirus Pneumonia in Wuhan, China: A Descriptive Study. Lancet. 2020;395(10223):507-13.
Rodriguez-MoralesAJ,Cardona-OspinaJA,Gutiérrez-OcampoE,Villamizar-Pena R, Holguin-Rivera Y, Escallera-Antezana JP, et al. Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-Analysis. Travel Med Infect Dis. 2020;(3)34.
Tsakok M, Shaw R, Murchison A, Ather S, Xie C, Watson R, et al. Diagnostic Accuracy of Initial Chest Radiograph Compared to SARS-CoV-2 PCR in Patients with Suspected COVID-19. BJR|Open. 2020;2(1):20200034.
Borghesi A, Maroldi R. COVID-19 Outbreak in Italy : Experimental Chest X-Ray Scoring System for Quantifying and Monitoring Disease Progression. Radiol Med. 2020;125(5):509-13.
Manna S, Wruble J, Maron SZ, et al. COVID-19: A Multimodality Review of Radiologic Techniques, Clinical Utility, and Imaging Features. Radiol Cardiothorac Imaging. 2020;2(3):e200210.
Zu ZY, Jiang Mdi, Xu PP, Chen W, Ni QQ, Lu GM, et al.Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology. 2020;296(2):E15-E25.
Guan W, Ni Z, Hu Y, W Liang, C Ou, J He, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. 2020. N Engl J Med. 2020;382:1708-20.
COVID-19 STP. Peta Sebaran. Satgas Penanganan COVID-19. 2021. https://covid19.go.id/peta-sebaran. Diakses 3 April, 2021.
Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical Characteristics of 140 Patients Infected with SARS-Cov-2 in Wuhan, China. Allergy Eur J Allergy Clin Immunol. 2020;75(7):1730-1741.
Borghesi A, Zigliani A, Masciullo R, Golemi S, Maculotti P, Farina D, et al. Radiographic Severity Index in COVID-19 Pneumonia: Relationship to Age and Sex in 783 Italian Patients. Radiol Medica. 2020;125(5):461-464.
Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP. The Trinity of COVID-19: Immunity, Inflammation and Intervention. Nat Rev Immunol. 2020;20(6):363-374.
Shang J, Wang Q, Zhang H, Wang X, Wan J, Yan Y, et al. The Relationship between Diabetes Mellitus and COVID-19 Prognosis: A Retrospective Cohort Study in Wuhan, China. Am J Med. 2021;134(1):e6-e14.
Yue H, Bai X, Wang J, Yu Q, Liu W, Pu J, et al. Clinical Characteristics of Coronavirus Disease 2019 in Gansu Province, China. Ann Palliat Med. 2020;9(4):1404-1412.
Hu L, Chen S, Fu Y, Gao Z, Long H, Ren HW, et al. Risk Factors Associated with Clinical Outcomes in 323 Coronavirus Disease 2019 (COVID-19) Hospitalized Patients in Wuhan, China. Clin Infect Dis. 2020;71(16):2089-98.
Yuki K,Fujiogi M, Koutsogiannaki S.COVID-19 Pathophysiology: A Review. Clin Immunol. 2020;215:108427.
Giri M, Puri A, Wang T, Guo S. Comparison of Clinical Manifestations, Pre-Existing Comorbidities, Complications and Treatment Modalities in Severe and Non-Severe COVID-19 Patients: A Systemic Review and Meta-Analysis. Sci Prog. 2021;104(1):1-24.
Surveillances V. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145-151.
Lian JS, Cai H, Hao SR, Jin X, Zhang XL, Zheng L, et al. Comparison of Epidemiological and Clinical Characteristics of COVID-19 Patients with and without Wuhan Exposure. J Zhejiang Univ Sci B. 2020;21(5):369-377.
Weinstock MB, Echenique A, Russel JW, Leib A, Miller JA, Cohen DJ, et al. Chest X-Ray Findings in 636 Ambulatory Patients with COVID-19 Presenting to an Urgent Care Center: A Normal Chest X-Ray is No Guarantee Contrast Reaction View Project Pancreatic IRE View Project. J Urgent Care Med. 2020;14(7):13-18.
Kaleemi R, Hilal K, Arshad A, Martins RS, Nankani A, Haq TU, et al. The Association of Chest Radiographic Findings and Severity Scoring with Clinical Outcomes in Patients with COVID-19 Presenting to the Emergency Department of a Tertiary Care Hospital in Pakistan. PLoS One. 2021;16:1-11.
Toussie D, Voutsinas N, Finkelstein M, Cedillo MA, Manna S, Maron SZ, et al. Clinical and Chest Radiography Features Determine Patient Outcomes in Young and Middle-Aged Adults with COVID-19. Radiology. 2020;297(1):E197-E206.
Borghesi A, Zigliani A, Golemi S, Carapella N, Maculotti P, Farina D, et al. Chest X-Ray Severity Index as a Predictor of In-Hospital Mortality in Coronavirus Disease 2019: A Study of 302 Patients From Italy. Int J Infect Dis. 2020;96:291-293.
Wong HYF, Lam HYS, Fong AHT, Leung ST, Chin TWY, Lo CSY, et al. Frequency and Distribution of Chest Radiographic Findings in Patients Positive for COVID-19. Radiology. 2020;296(2):E72-E78.
Blain M, Kassin MT, Varble N, Wang X, Xu Z, Xu D, et al. Determination of Disease Severity in COVID-19 Patients Using Deep Learning in Chest X-Ray Images. Diagnostic Interv Radiol. 2021;27(1):20-27.
Cozzi D, Albanesi M, Cavigli E, et al. Chest X-Ray in New Coronavirus Disease 2019 (COVID-19) Infection: Findings and Correlation with Clinical Outcome. Radiol Medica. 2020;125(8):730-7.
Li J, Xu G, Yu H, Peng X, Luo Y, Cao C. Clinical Characteristics and Outcomes of 74 Patients with Severe or Critical COVID-19. Am J Med Sci. 2020;360(3):229-35.
Xia F, Zhang M, Cui B, An W, Chen M, Yang P, et al. COVID ‑ 19 Patients with Hypertension are at Potential Risk of Worsened Organ Injury. Sci Rep. 2021:1-10.
Roy S, Mazumder T, Banik S. The Association of Cardiovascular Diseases and Diabetes Mellitus with COVID-19 (SARS-CoV-2) and Their Possible Mechanisms. SN Compr Clin Med. 2020;2(8):1077-82.
Gupta R, Ghosh A, Singh AK, Misra A. Clinical Considerations for Patients with Diabetes in Times of COVID-19 Epidemic. Diabetes Metab Syndr Clin Res Rev. 2020;14(3):211-12.
Angelidi AM, Belanger MJ, Mantzoros CS. Commentary: COVID-19 and Diabetes Mellitus: What We Know, How Our Patients should be Treated Now, and What Should Happen Next. Metabolism. 2020;107:154245.
Surendra H, Elyazar IRF, Djaafara BA, Ekawati LL, Saraswati K, Adrian V, et al. Clinical Characteristics and Mortality Associated with COVID-19 in Jakarta, Indonesia: A Hospital-Based Retrospective Cohort Study. Lancet Reg Health West Pac. 2021 Apr;9:100108.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.
Chen Y, Gong X, Wang L, Guo J. Effects of Hypertension, Diabetes and Coronary Heart Disease on COVID-19 Diseases Severity: A Systematic Review and Meta-Analysis. medRxiv. 2020.03.25.20043133.
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