Urooj Kanwal, Shazia Kadri, Naveed Ahmed, Mukhtiar A Memon: Dow University Of Health Sciences Karachi, Tariq Mehmood.
Chest x-ray (first tool of imaging) in COVID-19 patients radiological and clinical correlation - a tertiary care experience at Jinnah Postgraduate Medical Centre, Karachi.
Pak J Med Res Jan ;60(3):104-10.

Background: COVID-19 infection is the name given to respiratory illness caused by novel coronavirus (nCov) which is a new strain emerged in China in December 2019 that has not been previously identified in humans. Coronaviruses are a large family of viruses that cause illness ranging from common cold to severe respiratory symptoms of pneumonia. As there is no fixed definition of COVID-19 pneumonia, in this article we use tis term for patients who clinically showed up with respiratory symptoms along with radiological evidence of disease. Objective: The objective was to correlate the chest x-ray findings of all symptomatic COVID-19 PCR (polymerase chain reaction) positive patients admitted in COVID-19 isolation ward, Jinnah Postgraduate Medical Centre (JPMC), Karachi and assess the extent of baseline illness with progression or regression of disease radio graphically through serial chest X-rays and clinically with repeated viral nucleic acid testing. Study type, settings & duration: A prospective observational study was conducted at JPMC from 1st May to 31st May 2020. Methodology: All RT-PCR COVID-19 positive patients included who were admitted at isolation ward. Baseline and serial chest x-rays of suspected and already diagnosed patients were performed using portable x-ray machine dedicated in COVID-19 isolation ward. Results: Sixty four patients were studied over a period of one month, 42 males (66%) and 22 females (35%) in the age range of 16-75 years were included. The 23% patients with mild symptoms had normal chest radiograph initially progressed gradually with classical radiographic features had severity score (2) to moderate to severe involvement of lungs on an average 8-10 days after symptom onset with severity score =>3. The 7% patients with moderate symptoms showed moderate baseline chest x-ray COVID-19 features of severity score=>3 at the time of admission. The 44% patients with severe symptoms showed diagnostic baseline chest x-ray features with severity score =>4. Conclusion: Symptomatic COVID-19 positive patients showed chest x-ray features of mild to moderate ground glass opacities in sub pleural and peripheral distribution whereas in severe cases superimposed consolidation was also frequently noticed. Key words: Chest x-rays (CXR), RT-PCR (Real time polymerase chain reaction), consolidation, interstitial features, multifocal.

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