A descriptive retrospective hospital based review of chest x ray findings of Sri Lankan Covid 19 patients in a single centre (National Institute of Infectious Disease) in Sri Lanka

COVID-19 ravaging through the world and third world countries with limited resources envisages a cost effective and feasible imaging and prognostication score. We aim to develop a prognostication score based on the first chest X-ray to assess deterioration and need to transfer to specialized treatment units should the wave of COVID – 19 surge to higher levels. A retrospective study reviewing chest X rays and case notes were analyzed by two radiologists and in case of disagreement a third radiologist was consulted. The lung changes were classified using Fleischner Society Glossary of Terms for Thoracic Imaging. Each lung was divided into 4 zones and a score of 1 given to each affected zone. The total score was used to prognosticate. Of the 146 patients there was a male preponderance.  In 26.7%, the initial chest X-rays were abnormal. The peripheral, lower zone and bilateral involvement was more common. The scores of the initial chest X-ray correlated with the severity of the disease. With a sensitivity of 31.6%, chest X-ray is a poor screening investigation but with a specificity of 96.2% it can be used to prognosticate the outcome and monitor the progression of the disease.