Morphological patterns and distributions in portable chest radiographs of COVID-19-positive cases admitted to a tertiary care hospital: An early experience from Scandinavia.

INTRODUCTION:Chest radiographic (CXR) features, particularly portable CXR findings, of COVID-19 have not yet been systematically described, either as a baseline tool or as a follow-up method, despite the continuing global pandemic. There is a marked paucity of articles detailing the CXR findings vis-à-vis a multitude of articles dedicated to the CT features of COVID-19. The purpose of this article is to describe the morphological and distributional patterns of the lung opacities in CXR and to classify the spectrum of essential features on portable AP chest radiographs of PCR-positive COVID-19 patients admitted in a tertiary care hospital in Scandinavia. To our knowledge, this is the first article to describe the morphological and topographical features of CXRs in COVID-19-positive cases. METHODS:A retrospective analysis of twenty (20) RT-PCR-positive COVID-19 patients admitted to the hospital between 12.03.2020 to 10.04.2020 was done in this study. Morphology and distribution of the opacities were reviewed by two senior consultants and analysed for patterns. RESULTS:Most patients had ground-glass opacities (80-85%) and interspersed interstitial opacities (70-75%), often with a characteristic appearance. The opacities were mostly bilateral (80%) and distributed in the lower zones (and to some extent mid zones) and in the middle and peripheral regions, with a tendency to merge towards the hilar areas. There were high interobserver agreements among various parameters and no significant statistical difference between observer 1 and 2. CONCLUSION:Chest radiographics show characteristic patterns and distributions, which can be used as an adjunct in the diagnosis and follow-up of COVID-19 patients in specific clinical contexts.