• Hyunjoong W Kim, K M Capaccione, Gen Li, Lyndon Luk, Reginald S Widemon, Ozair Rahman, Volkan Beylergil, Ryan Mitchell, Belinda M D'Souza, Jay S Leb, Shifali Dumeer, Stuart Bentley-Hibbert, Michael Liu, Sachin Jambawalikar, Austin John H M JHM Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY, 10032, USA., and Mary Salvatore.
• Department of Radiology, Columbia University Irving Medical Center, 622 W 168th Street, New York, NY, 10032, USA. hyk9023@nyp.org.
• Emerg Radiol. 2020 Dec 1; 27 (6): 617-621.

PurposeThe purpose of our research is to evaluate the usefulness of chest X-ray for triaging patients with suspected COVID-19 infection.MethodsIRB approval was obtained to allow a retrospective review of adult patients who presented to the Emergency Department with a complaint of fever, cough, dyspnea or hypoxia and had a chest X-ray between 12 March 2020 and 26 March 2020. The initial chest X-ray was graded on a scale of 0-3 with grade 0 representing no alveolar opacities, grade 1: < 1/3 alveolar opacities of the lung, Grade 2: 1/3 to 2/3 lung with alveolar opacities and grade 3: > 2/3 alveolar opacities of the lung. Past medical history of diabetes and hypertension, initial oxygen saturation, COVID-19 testing results, intubation, and outcome were also collected.ResultsFour hundred ten patient chest X-rays were reviewed. Oxygen saturation and X-ray grade were both significantly associated with the length of stay in hospital, the hazard ratio (HR) of discharge was 1.05 (95% CI [1.01, 1.09], p = 0.017) and 0.61 (95% CI [0.51, 0.73], p < 0.001), respectively. In addition, oxygen saturation and X-ray grade were significant predictors of intubation (odds ratio (OR) of intubation is 0.88 (95% CI [0.81, 0.96], p = 0.004) and 3.69 (95% CI [2.25, 6.07], p < 0.001).ConclusionsInitial chest X-ray is a useful tool for triaging those subjects who might have poor outcomes with suspected COVID-19 infection and benefit most from hospitalization.

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