Covid x ray findings

1. Chest Xray findings in COVID -19
DEV LAKHERA

2. ◦ For COVID-19 pneumonia few early studies which have been done show radiologic
similarities to SARS and MERS pneumonia
◦ Predominance of bilateral GGO and consolidative lesions in the peripheral lung
◦ Despite the similarities in CT findings, COVID-19 pneumonia seems radiologically milder
than SARS and MERS pneumonia.
◦ The proportion of patients with abnormal initial radiographic findings was 78.3–82.4% in
SARS and 83.6% in MERS, but only 33% in cases of COVID-19 pneumonia (*KJR Chest
Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine
Patients Treated in Korea).

3. In a cohort of 64 patients ** with COVID-19 infection and imaging follow-up, baseline chest
x-ray had a sensitivity of 69%, compared to 91% for initial RT-PCR.
**Frequency and Distribution of Chest Radiographic Findings in COVID-19 Positive
Patients. Radiology Mar 27 2020

4. Chest Radiographic Findings
Laterally:
Equally involves both lung fields
Cephalocaudal distribution:
Lower > middle > upper
Central to peripheral distribution:
Peripheral >> central / central and
peripheral
Shape of opacity:
Patchy >>> Nodular
Density:
Consolidation > Ground glass lesions
Pleural effusion
Highly uncommon (3%)

5. Case 1: COVID -19 confirmed patient
Anteroposterior chest radiograph
shows multifocal patchy peripheral
consolidations in bilateral lungs,
except for left upper lung zone

6. Representative CT in same patient

7. Peripheral distribution of opacity Perihilar distribution of opacity

8. Evolution of disease in a COVID positive patient over 7 days
Day 1 Day 4
Normal Patchy, ill-defined bilateral alveolar consolidations,
with a peripheral distribution

9. Day 7
Radiological worsening, with typical
findings of acute respiratory distress
syndrome (ARDS).

10. Atypical presentation :Case II confirmed covid
Anteroposterior chest
radiograph shows
single nodular
consolidation (arrows)
in left lower lung zone.

11. Conclusion
Chest X-ray has low sensitivity for COVID-19.
Chest X-ray can be normal in large number of patients.
Typical findings include - Patchy consolidating opacities in peripheral and lower lobar
distribution.
References
KJR Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19):
Analysis of Nine Patients Treated in Korea
Frequency and Distribution of Chest Radiographic Findings in COVID-19 Positive Patients.
Radiology Mar 27 2020

12. THANK YOU