The Role of Chest Radiography in the COVID-19 Pandemic: Retrospective Study of Patients from a University Hospital in Brazil

In December 2019, the World Health Organization (WHO) reported an outbreak of pneumonia in Wuhan, China, caused by severe acute respiratory syndrome coronavirus 2. Computed tomography (CT) is the primary imaging modality used to diagnose and monitor severe acute respiratory syndrome caused by SARS-CoV-2. However, its routine use is expensive and produces large amounts of radiation. The aim of this study was to define chest radiography (CXR) patterns for COVID-19 and correlate them with clinical and outcome variables to achieve early and effective diagnosis using a cheaper and more accessible imaging method compared to CT. We analyzed CXR images and RT-PCR results of patients with COVID-19, categorizing them into typical, possible, atypical, or negative patterns. The results showed that CXR is effective and economical in evaluating COVID-19, with type 3 opacities associated with more severe outcomes and type 1 opacities with early stages of infection. Moreover, patients with comorbidities, age over 60 years, and the need for mechanical ventilation had worse outcomes. In conclusion, CXR can be an effective and inexpensive tool in the evaluation of COVID-19, especially in high-demand scenarios. Standardization of radiographic findings is also important for the improvement of diagnostic accuracy and clinical management of COVID-19.