Observational studyEuropean radiology2022
Early radiological worsening of SARS-CoV-2 pneumonia predicts the need for ventilatory support.
Observational study in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 13 citations in OpenAlex.
- Early chest x-ray severity assessed by the MBrixia score is associated with mortality in hospitalized patients with COVID-19 pneumonia.Scientific reports · 2026Article
- Early association between respiratory mechanics and radiological changes in mechanically ventilated critically ill patients with COVID-19.Internal and emergency medicine · 2024Article
- Characteristics of patients with COVID-19 who have deteriorating chest X-ray findings within 48 h: a retrospective cohort study.Scientific reports · 2023Article
- Digital tomosynthesis improves chest radiograph accuracy and reduces microbiological false negatives in COVID-19 diagnosis.Emergency radiology · 2023Article
- Chest X-ray severity score Brixia: From marker of early COVID-19 infection to predictor of worse outcome in internal medicine wards.European journal of clinical investigation · 2023Article
- Article
- Brixia and qSOFA Scores, Coagulation Factors and Blood Values in Spring versus Autumn 2021 Infection in Pregnant Critical COVID-19 Patients: A Preliminary Study.Healthcare (Basel, Switzerland) · 2022Article
- Dynamic of Serum TWEAK Levels in Critically Ill COVID-19 Male Patients.Journal of clinical medicine · 2022Article
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIdentifying early markers of poor prognosis of coronavirus disease 2019 (COVID-19) is mandatory. Our purpose is to analyze by chest radiography if rapid worsening of COVID-19 pneumonia in the initial days has predictive value for ventilatory support (VS) need.
methodsAmbispective observational ethically approved study in COVID-19 pneumonia inpatients, validated in a second outpatient sample. Brixia score (BS) was applied to the first and second chest radiography required for suspected COVID-19 pneumonia to determine the predictive capacity of BS worsening for VS need. Intraclass correlation coefficient (ICC) was previously analyzed among three radiologists. Sensitivity, specificity, likelihood ratios, AUC, and odds ratio were calculated using ROC curves and binary logistic regression analysis. A value of p < .05 was considered statistically significant.
resultsA total of 120 inpatients (55 ± 14 years, 68 men) and 112 outpatients (56 ± 13 years, 61 men) were recruited. The average ICC of the BS was between 0.812 (95% confidence interval 0.745-0.878) and 0.906 (95% confidence interval 0.844-0.940). According to the multivariate analysis, a BS worsening per day > 1.3 points within 10 days of the onset of symptoms doubles the risk for requiring VS in inpatients and 5 times in outpatients (p < .001). The findings from the second chest radiography were always better predictors of VS requirement than those from the first one.
conclusionThe early radiological worsening of SARS-CoV-2 pneumonia after symptoms onset is a determining factor of the final prognosis. In elderly patients with some comorbidity and pneumonia, a 48-72-h follow-up radiograph is recommended. KEY POINTS: • An early worsening on chest X-ray in patients with SARS-CoV-2 pneumonia is highly predictive of the need for ventilatory support. • This radiological worsening rate can be easily assessed by comparing the first and the second chest X-ray. • In elderly patients with some comorbidity and SARS-CoV-2 pneumonia, close early radiological follow-up is recommended.
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