Singh Narender, Pati Saroj Kumar, Bodhey Narendra Kuber, De Sajal, Behera Ajoy K
Radiodiagnosis, All India Institute of Medical Sciences, Raipur, IND.
Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences, Raipur, IND.
Cureus. 2025 Feb 13;17(2):e78942. doi: 10.7759/cureus.78942. eCollection 2025 Feb.
Chest radiography is often the most utilized and primary investigation for patients with COVID-19 pneumonia, however, only limited studies are available evaluating its essence. Therefore, we retrospectively analyzed various chest radiographic patterns in patients with COVID-19 and correlated the radiographic severity index with clinical severity and laboratory parameters.
In this retrospective study, radiographs of 512 COVID-19 patients diagnosed with pneumonia were assessed, out of which 289 patients satisfying inclusion and exclusion criteria were recruited for the study. The spectrum of radiographic findings was compared with the contemporary clinical and laboratory records.
Ground glass opacities (GGOs; 250/289, 86.5%) and consolidations (166/289, 57.4%) were the most common findings seen in radiographs, with the most common distributions being "basal and peripheral" (92/289, 31.9%), followed by "non-specific pattern" (73/289, 25.3%), "basal" (60/289, 20.8%), and "peripheral" (48/289, 16.6%) patterns. A statistically significant association was seen between the clinical and radiographic severity scores and in-hospital mortality and radiographic severity scores. Also, a statistically significant association was seen between the radiographic severity score and various laboratory parameters (i.e., white blood cell (WBC) count, lactate dehydrogenase (LDH), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR)).
With this study, we concluded that specific patterns of lung involvement were seen in patients with COVID-19 and that radiographic severity scores correlated well with the clinical severity and laboratory parameters. Hence, in our opinion, chest radiography could be a useful tool for stratifying disease severity and differentiating between severe and non-severe COVID-19 pneumonia.
胸部X线摄影常常是新型冠状病毒肺炎（COVID-19）患者最常用的主要检查手段，然而，评估其本质的研究有限。因此，我们回顾性分析了COVID-19患者的各种胸部X线影像模式，并将影像严重程度指数与临床严重程度及实验室参数进行关联分析。
在这项回顾性研究中，对512例诊断为肺炎的COVID-19患者的X线片进行了评估，其中289例符合纳入和排除标准的患者被纳入研究。将影像表现谱与同期的临床和实验室记录进行比较。
磨玻璃影（GGO；250/289，86.5%）和实变影（166/289，57.4%）是X线片中最常见的表现，最常见的分布为“基底及外周”（92/289，31.9%），其次为“非特异性模式”（73/289，25.3%）、“基底”（60/289，20.8%）和“外周”（48/289，16.6%）模式。临床严重程度评分与影像严重程度评分之间以及院内死亡率与影像严重程度评分之间存在统计学显著关联。此外，影像严重程度评分与各种实验室参数（即白细胞（WBC）计数、乳酸脱氢酶（LDH）、C反应蛋白（CRP）和红细胞沉降率（ESR））之间也存在统计学显著关联。
通过本研究，我们得出结论，COVID-19患者存在特定的肺部受累模式，且影像严重程度评分与临床严重程度及实验室参数具有良好的相关性。因此，我们认为，胸部X线摄影可能是一种用于对疾病严重程度进行分层以及区分重症和非重症COVID-19肺炎的有用工具。
