In a new study, researchers examined the usefulness of chest X-rays in COVID-19 and found they could aid in a rapid diagnosis of the disease, especially in areas with limited testing capacity or delayed test results.
The research was conducted by a team at Louisiana State University.
In mid to late March of this year, when COVID-19 cases were spiking in New Orleans, the team recognized an unusual pattern on chest X-rays that seemed to correlate with COVID positivity.
The radiologists conducted a retrospective study of nearly 400 persons under investigation (PUI) for COVID-19 in New Orleans.
They reviewed the patients’ chest X-rays along with concurrent reverse-transcription polymerase chain reaction (RT-PCR) virus tests.
Using well-documented COVID-19 imaging patterns, two experienced radiologists categorized each chest X-ray as characteristic, nonspecific, or negative in appearance for COVID-19.
The team found a characteristic chest X-ray appearance is highly specific (96.6%) and has a high positive predictive value of 83.8% for SARS-CoV-2 infection in the setting of the pandemic.
The team says the presence of patchy and/or confluent, band-like ground-glass opacity or consolidation in a peripheral and mid-to-lower lung zone distribution on a chest radiograph is highly suggestive of SARS-CoV-2 infection and should be used in conjunction with clinical judgment to make a diagnosis.
The chest radiograph, while low in sensitivity, can indicate COVID-19 in patients whose radiographs exhibit characteristic COVID-19 findings when used in concert with clinical factors.
While not a substitute for RT-PCR virus tests or Chest CT, radiographs could provide a rapid, cost-effective diagnosis of COVID-19 in a subset of infected patients during the COVID-19 pandemic.
The team says this discovery is useful to aid in diagnosis in the setting of pandemic spread of COVID-19, especially when adequate testing is lacking.
One author of the study is David Smith, MD, Associate Professor of Clinical Radiology.
The study is published in Radiology: Cardiothoracic Imaging.
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