COVID-19 x ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

An x-ray may be helpful in the diagnosis of COVID-19 infection. Findings of chest x-ray can be consistent with the disease severity and time of presentation. Chest X-ray findings of COVID-19 may be normal in early/mild disease. Findings are most extensive about 10-12 days after symptom onset. The most frequent findings are consolidation. The distribution is most often bilateral, peripheral, and lower zone predominant. In contrast to parenchymal disease, pleural effusion is rare.

X Ray

  • An x-ray may be helpful in the diagnosis of COVID-19 infection.[1][2]
  • Findings of chest x-ray can be consistent with the disease severity and time of presentation.
  • Chest X-ray findings of Covid-19 may be normal in early/mild disease.
  • Findings are most extensive about 10-12 days after symptom onset.
  • Findings on X-ray in severe COVID-19 infection include:
    • Airspace opacities (consolidation)
      • Often bilateral, peripheral, and lower zone predominant.
  • Pleural effusions are rare.
  • Table below provides information on the percentage of various x-ray findings in 636 patients with Covid-19 from Greater NYC UC Centers.
Radiologic Pattern Categories % of individuals
Severity Normal 58.3
Mild 30.7
Moderate 10.2
Severe 0.8
Type of Infiltrate Interstitial 23.7
Ground glass opacities 18.9
Consolidation 5.3
Location Lower 33.8
Upper 20.1
Diffuse 0.9
Number of Lesions One 24.2
Multiple 11.2
Location of lesions Central 7.1
Peripheral 35.4
Other findings Lymphadenopathy 0.3
Effusion 0.3
The above table adopted from JUCM The Journal of Urgent Care Medicine [3]

Image

COVID-19 pneumoni[4]
COVID-19 pneumonia[5]

References

  1. Weinstock MB, Echenique A, Russell JW, et al. Chest x-ray findings in 636 ambulatory patients with COVID-19 presenting to an urgent care center: a normal chest x-ray is no guarantee. J Urgent Care Med. April 13, 2020. [Epub ahead of print])
  2. Yoon, Soon Ho; Lee, Kyung Hee; Kim, Jin Yong; Lee, Young Kyung; Ko, Hongseok; Kim, Ki Hwan; Park, Chang Min; Kim, Yun-Hyeon (2020). "Chest Radiographic and CT Findings of the 2019 Novel Coronavirus Disease (COVID-19): Analysis of Nine Patients Treated in Korea". Korean Journal of Radiology. 21 (4): 494. doi:10.3348/kjr.2020.0132. ISSN 1229-6929.
  3. Weinstock MB, Echenique A, Russell JW, et al. Chest x-ray findings in 636 ambulatory patients with COVID-19 presenting to an urgent care center: a normal chest x-ray is no guarantee. J Urgent Care Med. April 13, 2020. [Epub ahead of print])
  4. Case courtesy of Dr Subhan Iqbal, Radiopaedia.org, rID: 76341
  5. Case courtesy of Dr Ian Bickle, Radiopaedia.org, rID: 75844