Nahar Shaima, Shamsun; Haque, Md Ahshanul; Sarmin, Monira; Nuzhat, Sharika; Jahan, Yasmin; Bushra Matin, Fariha; Shahrin, Lubaba; Afroze, Farzana; Saha, Haimanti; Timu, Rehnuma Tabassum; +6 more... Kamal, Mehnaz; Shahid, Abu Sadat Mohammad Sayeem Bin; Sultana, Nadia; Mamun, Gazi Md Salahuddin; Chisti, Mohammod Jobayer; Ahmed, Tahmeed; (2024) Performance of chest X-ray scoring in predicting disease severity and outcomes of patients hospitalised with COVID-19 in Bangladesh. SAGE Open Medicine, 12. 20503121231222325-. ISSN 2050-3121 DOI: https://doi.org/10.1177/20503121231222325
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Abstract
INTRODUCTION: Evaluation of potential outcomes of COVID-19-affected pneumonia patients using computed tomography scans may not be conceivable in low-resource settings. Thus, we aimed to evaluate the performance of chest X-ray scoring in predicting the disease severity and outcomes of adults hospitalised with COVID-19. METHODS: This was a retrospective chart analysis consuming data from COVID-19-positive adults who had chest X-ray availability and were admitted to a temporary COVID unit, in Bangladesh from 23rd April 2020 to 15th November 2021. At least one clinical intensivist and one radiologist combinedly reviewed each admission chest X-ray for the different lung findings. Chest X-ray scoring varied from 0 to 8, depending on the area of lung involvement with 0 indicating no involvement and 8 indicating ⩾75% involvement of both lungs. The receiver operating characteristic curve was used to determine the optimum chest X-ray cut-off score for predicting the fatal outcomes. RESULT: A total of 218 (82.9%) out of 263 COVID-19-affected adults were included in the study. The receiver operating characteristic curve demonstrated the optimum cut-off as ⩾3 and ⩾5 for disease severity and death, respectively. In multivariate logistic regression analysis, a chest X-ray score of ⩾3 was found to be independently associated with disease severity (aOR: 8.70; 95% CI: 3.82, 19.58, p < 0.001) and a score of ⩾5 with death (aOR: 16.53; 95% CI: 4.74, 57.60, p < 0.001) after adjusting age, sex, antibiotic usage before admission, history of fever, cough, diabetes mellitus, hypertension, total leukocytes count and C-reactive protein. CONCLUSION: Using chest X-ray scoring derived cut-off at admission might help to identify the COVID-19-affected adults who are at risk of severe disease and mortality. This may help to initiate early and aggressive management of such patients, thereby reducing their fatal outcomes.
Item Type | Article |
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Faculty and Department | Faculty of Public Health and Policy > Dept of Global Health and Development |
Research Centre | Covid-19 Research |
PubMed ID | 38264406 |
Elements ID | 214955 |
Official URL | http://dx.doi.org/10.1177/20503121231222325 |
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Licence: Creative Commons: Attribution-Noncommercial 4.0
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