Prognostic significance of peripheral consolidations at chest x-ray in severe COVID-19 pneumonia

Abstract

To evaluate the possible prognostic significance of the development of peripheral consolidations at chest x-ray in COVID-19 pneumonia, we retrospectively studied 92 patients with severe respiratory failure (PaO₂/FiO₂ ratio < 200 mmHg) that underwent at least two chest x-ray examinations (baseline and within 10 days of admission). Patients were divided in two groups based on the evolution of chest x-ray toward the appearance of peripheral consolidations or toward a greater extension of the lung abnormalities but without peripheral consolidations. Patients who developed lung abnormalities without peripheral consolidations as well as patients who developed peripheral consolidations showed, at follow-up, a significant worsening of the PaO₂/FiO₂ ratio but a significantly lower mortality and intubation rate was observed in patients with peripheral consolidations at chest x-ray. The progression of chest x-ray toward peripheral consolidations is an independent prognostic factor associated with lower intubation rate and mortality.

Keywords: COVID-19; Chest x-ray; Consolidation; Prognosis.