The characteristic imaging findings during the different stages of the disease and the variation in the prevalence of the different patterns are also studied. We aim to determine the most common appearances of lung abnormalities in COVID-19 patients to provide insight into the initial CXR as well as follow-up CXR characteristics of this infectious disease. The value of radiographic imaging is in generating results that are clinically actionable either for establishing a diagnosis or for guiding patient management. This review intends to analyze the characteristics of the rapidly progressive COVID-19 viral pneumonia on CXR. Although CXR is less sensitive, it is available in urgent care centers, clinics and hospitals and may help with COVID-19 diagnosis 7.Īvailable information on CXR features of COVID-19 is dispersed among various published papers in the scientific literature, and a consolidated systematic review has yet to be assembled.

CXR obtained from confirmed and symptomatic COVID-19 patients have had a lower sensitivity at 69% 4. The diagnostic performance of CXR in the early stages of COVID-19 is, however, limited and pathological findings may not be detected on radiography that is identifiable on chest CT 8. The pulmonary system is primarily affected by COVID-19, as such, it is common practice to request a chest radiograph (CXR) in suspicious cases as the initial imaging exam. Chest CT has been found to have comparable diagnostic performance with a sensitivity of 77% and specificity of 96% 3.

The gold standard for diagnosing COVID-19 patients is a viral nucleic acid test conducted by reverse transcription-polymerase chain reaction (RT-PCR) with a sensitivity of 79% and specificity of 100% 2. Healthcare workers need diagnostic tools to study cases of potential COVID-19 that are both sensitive and specific 7. The first case of coronavirus disease 2019 (COVID-19) was first reported in Wuhan, China in December 2019 and it was declared a pandemic by the World Health Organization (WHO) in March 2020 1. Contrary to parenchymal abnormalities, pneumothorax (1%, 95% CI: 0–3%) and pleural effusions (6%, 95% CI: 1–16%) were rare. The most common abnormalities were consolidation (28%, 95% CI: 8–54%) and ground-glass opacities (29%, 95% CI: 10–53%). While there was no single feature on CXR that was diagnostic of COVID-19 viral pneumonia, a characteristic set of findings were obvious. Seventy-four percent (74%) (95% CI: 51–92%) of patients with COVID-19 had an abnormal CXR at the initial time of diagnosis or sometime during the disease course. To perform the meta-analysis, a random-effects model calculated the pooled prevalence and 95% confidence intervals of abnormal CXR imaging findings. A total of 1948 patients were included in this study.

The inclusion criteria consisted of: (1) published in English literature (2) original research study (3) sample size of at least 5 patients (4) reporting clinical characteristics of COVID-19 patients as well as CXR imaging features and (5) noting the number of patients with each corresponding imaging feature. Twelve studies met the inclusion criteria and were analyzed. This review provides a meta-analysis of the current literature on CXR imaging findings to determine the most common appearances of lung abnormalities in COVID-19 patients in order to equip medical researchers and healthcare professionals in their efforts to combat this pandemic. Chest radiography (CXR) is most likely to be the utilized modality for diagnosing COVID-19 and following up on any lung-associated abnormalities.

Pneumonia cxr findings