Radiographic findings in 240 patients with COVID-19 pneumonia

Abstract Objective: to analyze the most frequent radiographic features of COVID-19 pneumonia and assess the effectiveness of CXR in detecting pulmonary alterations.Materials and Methods: CXR of 240 symptomatic patients (70% male, mean age 65±16 years), with SARS-CoV-2 infection confirmed by RT-PCR were retrospectively evaluated. Patients were clustered in four groups based on the number of days between symptom onset and CXR: A (0-2 days) 49 patients, B (3-5) 75 patients, C (6- 9) 85 patients and D (>9) 31 patients. Alteration’s type (reticular/opacification/consolidation) and distribution (bilateral/unilateral, upper/middle/lower fields, peripheral/central) were noted. Statistical significance was tested using chi-squared test.Results: among 240 CXR, 60 (25%) were negative (A 36.7%, B 28%, C 18.8%, D 16.1%). Opacification was observed in 124/180 (68.8%), reticular alteration in 113/180 (62.7%), consolidation in 71/180 (39.4%). Consolidation was significantly less frequent (p<0.01). Distribution among groups was: reticular alteration (A 70.9%, B 72.2%, C 57.9%, D 46.1%), opacification (A 67.7%, B 62.9%, C 71%, D 76.9%), consolidation (A 35.5%, B 31.4%, C 47.8%, D 38.5%). Alterations were bilateral in 73.3%. Upper, middle and lower fields were involved in 36.7%, 79.4%, 87.8%. Lesions were peripheral in 49.4%, central in 11.1% or both in 39.4%. Upper fields and central zones were significantly less involved (p<0.01). Conclusions: the most frequent lesions in COVID-19 patients were opacification (intermediate/late phase) and reticular alteration (early phase) while consolidation gradually increased over time. The most frequent distribution was bilateral, peripheral, with middle/lower predominance. Overall rate of negative CXR is 25%, progressively decreased over time.