• Aparajita Singh, Yoke Hong Lim, Rajesh Annamalaisamy, Shyam Sunder Koteyar, Suresh Chandran, Avinash Kumar Kanodia, and Navin Khanna.
• Fellow, Radiology, The Royal Oldham Hospital (Northern Care Alliance), UK.
• Scot Med J. 2021 Aug 1; 66 (3): 101-107.

ObjectivesTo devise a novel, simple chest x-ray (CXR) scoring system which would help in prognosticating the disease severity and ability to predict comorbidities and in-hospital mortality.MethodsWe included a total of 343 consecutive hospitalised patients with COVID-19 in this study. The chest x-rays of these patients were scored retrospectively by three radiologists independently. We divided CXR in to six zones (right upper, mid & lower and left, upper mid & lower zones). We scored each zone as- 0, 1 or 2 as follows- if that zone was clear (0) Ground glass opacity (1) or Consolidation (2). A total of score from 0 to 12 could be obtained.ResultsA CXR score cut off ≥3 independently predicted mortality. Along with a relatively higher NPV ≥80%, it reinforced the importance of CXR score is a screening tool to triage patients according to risk of mortality.ConclusionsWe propose that Pennine score is a simple tool which can be adapted by various countries, experiencing a large surge in number of patients, to decide which patient would need a tertiary Hospital referral/admission as opposed to patients that can be managed locally or at basic/primary care hospitals.

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