Evaluation of the initial chest X-ray in the management of adult patients with COVID-19
Keywords:
COVID-19, chest X-ray, radiology, validity of a diagnostic testAbstract
Introduction: In the context of the COVID-19 pandemic, the lack of diagnostic tests or kits, together with difficulties related to sensitivity and the delay in reporting the results undermined expeditious decision-making when the patient attended the emergency services; this fact is more marked in high prevalence scenarios, which affected adequate isolation and care in general.
Objective: To evaluate the usefulness of the initial chest X-ray in the management of adult patients with COVID-19.
Methods: A cross-sectional, retrospective, analytical evaluation study was carried out in adult patients. The results of the initial chest X-ray were compared with those of the reference standard for SARS-CoV-2, and sensitivity, specificity and predictive values were used as validity indicators.
Results: The predominant radiological finding was ground-glass opacity (22.42%). Most patients had mild involvement (score 1-2), with a weighted mean severity of 1.29. 82.35% of patients with mild involvement, and 100% with moderate-severe involvement required hospitalization. Chest X-ray showed a sensitivity of 72.13% and a specificity of 12.90%, with a positive predictive value of 61.97%.
Conclusions: Initial chest X-ray in patients with COVID-19 had moderate sensitivity and low specificity, but it is useful for detecting lung involvement, guiding treatment, and predicting the need for hospitalization. Its availability and low cost make it a valuable tool, especially in resource-limited settings.
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