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胸部X光在2019冠状病毒病(COVID-19)感染中的作用:研究结果及与临床结局的相关性

The role of chest X-ray in coronavirus disease 2019 (COVID-19) infection: findings and correlation with clinical outcome.

作者信息

Ozdemir B, Akinci E, Koksal M, Rodoplu E, Altunsoy A, Guner R, Kayaaslan B, Kalem A K, Hasanoglu I, Eser F, Ayhan M, Saricaoglu E M, Bilir Y A, Coskun B

机构信息

Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2023 Jul;27(14):6563-6572. doi: 10.26355/eurrev_202307_33127.

Abstract

OBJECTIVE

It is possible to diagnose coronavirus disease 2019 (COVID-19) faster and more accurately with chest X-ray (CXR) and chest computed tomography (CT) than with reverse transcriptase PCR (RT-PCR) tests. The aim of this study was to verify the possibility of reducing the use of CT in diagnosis and follow-up of COVID-19 infection by using CXR.

PATIENTS AND METHODS

A total of 326 COVID-19 patients who were hospitalized in Ankara City Hospital were included in this retrospective study.

RESULTS

A total of 326 patients were RT-PCR positive for COVID-19 infection; 178 were male (54.6%) and 148 were female (45.4%), with a median age of 45. Considering the results, the baseline CXR sensitivity in our experience was approximately 72%. The CXRs of 113 patients with abnormal CT were divided into 2 groups, the CXR normal and abnormal groups, and were then compared. In the 1st group with abnormal CXR, the mean age, the number of patients over 65 years old, and the comorbidity rate were higher. Additionally, it was determined that the number of patients requiring respiratory support and intensive care unit (ICU) admission in this 1st group was higher than in the 2nd group (with normal CXR). Most of the patients who died (91%, 10/11) were in Group 1. In the group with normal CXR, no patients in the critically ill category needed invasive or non-invasive mechanical ventilators.

CONCLUSIONS

CXR can help in detecting clinically moderate and severe cases of COVID-19. CXR can assist clinicians in patient management and treatment planning regarding the clinical course, respiratory support, ICU need, and mortality and can help them prepare for potential negative outcomes.

摘要

目的

与逆转录聚合酶链反应(RT-PCR)检测相比,胸部X线(CXR)和胸部计算机断层扫描(CT)能够更快、更准确地诊断2019冠状病毒病(COVID-19)。本研究的目的是验证通过使用CXR减少CT在COVID-19感染诊断和随访中的使用可能性。

患者和方法

本回顾性研究纳入了在安卡拉市立医院住院的326例COVID-19患者。

结果

共有326例患者COVID-19感染的RT-PCR检测呈阳性;男性178例(54.6%),女性148例(45.4%)。中位年龄为45岁。根据结果,在我们的经验中,基线CXR敏感性约为72%。113例CT异常患者的CXR分为CXR正常组和异常组,然后进行比较。在CXR异常的第一组中,平均年龄、65岁以上患者数量和合并症发生率更高。此外,确定该第一组中需要呼吸支持和入住重症监护病房(ICU)的患者数量高于第二组(CXR正常)。大多数死亡患者(91%,10/11)在第一组。在CXR正常的组中,危重症患者中没有患者需要有创或无创机械通气。

结论

CXR有助于检测COVID-19的临床中度和重度病例。CXR可协助临床医生进行患者管理和治疗规划,涉及临床病程、呼吸支持、ICU需求以及死亡率,并可帮助他们为潜在的负面结果做好准备。

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