Cardiothoracic ImagingPortable chest X-ray in coronavirus disease-19 (COVID-19): A pictorial review
Highlights
- •
COVID-19 lung infection commonly produces ground glass and consolidative opacities with a bilateral, peripheral, and lower lung distribution.
- •
Portable CXR will likely be the primary imaging modality used in diagnosis and management of COVID-19 patients.
- •
With high clinical suspicion for COVID-19 infection, positive CXR findings can obviate the need for CT scanning.
- •
Lung opacities can rapidly evolve into a diffuse pattern within weeks after symptom onset, often peaking at around 6-12 days.
Abstract/introduction
As the global pandemic of coronavirus disease-19 (COVID-19) progresses, many physicians in a wide variety of specialties continue to play pivotal roles in diagnosis and management. In radiology, much of the literature to date has focused on chest CT manifestations of COVID-19 (Zhou et al. [1]; Chung et al. [2]). However, due to infection control issues related to patient transport to CT suites, the inefficiencies introduced in CT room decontamination, and lack of CT availability in parts of the world, portable chest radiography (CXR) will likely be the most commonly utilized modality for identification and follow up of lung abnormalities. In fact, the American College of Radiology (ACR) notes that CT decontamination required after scanning COVID-19 patients may disrupt radiological service availability and suggests that portable chest radiography may be considered to minimize the risk of cross-infection (American College of Radiology [3]). Furthermore, in cases of high clinical suspicion for COVID-19, a positive CXR may obviate the need for CT. Additionally, CXR utilization for early disease detection may also play a vital role in areas around the world with limited access to reliable real-time reverse transcription polymerase chain reaction (RT-PCR) COVID testing.
The purpose of this pictorial review article is to describe the most common manifestations and patterns of lung abnormality on CXR in COVID-19 in order to equip the medical community in its efforts to combat this pandemic.