Abstract

More than 6 million people died due to COVID-19 (coronavirus disease-19) with more than 4.5 billion people infected worldwide, while the pandemic continues. The significance of prompt, accurate and readily available diagnostic tools that can be used for early diagnosis and subsequent management evoked the need for analyzing performance of an easily accessible modality of CXR (Chest X-Ray) with respect to resource intensive High Resolution Computed Tomography (HRCT) scans of thorax. This observational, cross-sectional study analyzed imaging data of 200 patients clinically suspected to have atypical pneumonia and who were categorized as CO-RADS 4 or above on their HRCT chest scans and had CXR, HRCT scan done on the same day from April 2020 to May 2021 in Department of Radio-diagnosis, Dr. S. N. Medical College, Mahatma Gandhi Hospital, Jodhpur. In our study, the 200 patients having mean age of 47 years, median of 45 years (65% males and 35% females) showed predominantly ground glass opacity (GGO) as sole finding in 129 patients (64.5%); GGO with consolidation in 45 patients (22.5%); GGO with reticulation in 15 patients (7.5%); GGO with consolidation and reticulation in 5 patients (2.5%); exhibiting no significant difference in pattern based on age and gender. The distribution of ground glass opacity or consolidation was predominantly in the lower and mid- peripheral lung zones. Pleural effusion, lymphadenopathy are uncommon and atypical findings. On comparing HRCT severity score and CXR severity scores for Cohen- kappa inter- rater agreement, the value of ‘k’ (k= kappa coefficient) came as 0.27558 (linear weights) for CXR score and CT score, which falls under “fair agreement” category. For the grading of severity, it came as 0.72772 and 0.65083 on linear and quadratic weights respectively, effectively meaning “good” agreement between the two modalities

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