Research Articles
CXR severity scores of COVID 19 infection in Sri Lanka: findings of a multicenter study during the first wave of the pandemic
Authors:
U. A. Liyanage ,
University of Colombo, LK
About U. A.
Faculty of Medicine
K. Abeywardana,
National Institute of Infectious Dideases, LK
About K.
Department Radiology
D. P. A. Gunasekara,
Welikanda Hospital, Polonaruwa, LK
About D. P. A.
Department of Radiology
P. V. R. De Mel,
Colombo East Base Hospital, LK
About P. V. R.
Department of Radiology
A. R. M. S. Ranathunga,
Base Hospital Homagama, LK
About A. R. M. S.
Department of Radiology
K. Lakmal,
University of Colombo, LK
About K.
Faculty of Medicine
S. H. Palihawadana,
National Hospital for Respiratory Diseases, LK
About S. H.
Department of Radiology
S. H. De Silva Weliange
University of Colombo, LK
About S. H.
Faculty of Medicine
Abstract
Introduction
Chest X-ray initially remained the only imaging modality in the first wave of the COVID -19 pandemic in Sri Lanka similar to many other low resource settings. Sri Lanka claimed a cluster epidemic status achieving a case fatality rate well below the global rate during the first wave.
Objectives
To describe degree of lung involvement on CXR as a severity score and correlate severity scores with symptom duration, presence of comorbidities and demographic factors.
Methods
A retrospective study at four main hospitals in Sri Lanka included all RT-PCR positive COVID-19 patients who underwent CXR from January to mid May, 2020. Both initial and follow-up CXR were independently double reported by a team of four radiologists and discrepancy reported by a fifth radiologist for radiographic findings and lung involvement. Clinical and demographic data was retrieved from hospital records. A severity score was calculated for each CXR. Associations were analyzed for CXRs with a severity score of 1 or more.
Results
217 CXRs of 133 patients (99 men, mean age 43.9±15.7 years;133 initial CXRs of 132 symptomatic patients; 84 follow-up radiographs of 33 patients) revealed 96(96/133;72.2%) normal initial CXRs. 12 patients with normal initial CXRs(12/96;12.5%) underwent follow up CXR but none was abnormal. Majority (21/37;56.75%) with abnormal CXR had mild (severity score 1-2) lung involvement. A severity score of 1 or more was associated with comorbidities (OR=3.14), male sex (OR=5.93) and increasing age (OR=1.06).
Conclusion
Majority of CXR in COVID-19 patients were normal during first wave in Sri Lanka. Majority with abnormal CXR had mild lung involvement.
How to Cite:
Liyanage, U.A., Abeywardana, K., Gunasekara, D.P.A., De Mel, P.V.R., Ranathunga, A.R.M.S., Lakmal, K., Palihawadana, S.H. and De Silva Weliange, S.H., 2022. CXR severity scores of COVID 19 infection in Sri Lanka: findings of a multicenter study during the first wave of the pandemic. Sri Lanka Journal of Radiology, 8(1), pp.9–23. DOI: http://doi.org/10.4038/sljr.v8i1.111
Published on
09 Aug 2022.
Peer Reviewed
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