Upon second inspection, 371 (58.3%) of the 636 chest X-rays were classified as normal. Of the 636 X-rayed patients, 363 (57.1%) were male. The radiologists were instructed to disregard the initial interpretations and to classify each film as indicating normal, mild, moderate, or severe disease. The radiologists who had initially read the films did not know the diagnostic status of the patients because of limited testing in March. Therefore, to quantify how often chest X-ray reveals abnormalities consistent with COVID-19 in the urgent care setting, Weinstock and colleagues asked board-certified radiologists to re-read chest X-rays taken at more than 100 urgent care facilities in urban New York and New Jersey between March 9 and March 24.Įleven radiologists re-read 47 to 100 chest x-rays each, totaling 636 images, from patients who were eventually confirmed to have symptomatic COVID-19. By contrast, chest X-ray is less sensitive, but widely available in urgent care centers and may help with COVID-19 diagnosis. However, CT is too costly and cumbersome to be part of a COVID-19 work-up in the urgent care setting. Many early imaging studies of COVID-19 used CT to characterize the peculiarities of SARS-CoV-2 infection.
Doctors should not be reassured by a negative chest X-ray," said lead author Michael Weinstock, MD, an adjunct professor of emergency medicine at The Ohio State University College of Medicine in Columbus and a senior editor for JUCM. "Providers ordering a chest X-ray in the outpatient setting should be aware that a patient with symptoms of COVID-19 may have a negative chest X-ray and should manage the patient based on their symptoms. What your doctor is reading on :ĪP- Patients presenting at urgent care centers with symptoms that warrant suspicion of COVID-19 may have normal chest X-rays yet still be infected with SARS-CoV-2, according to findings of a study published online April 13 in the Journal of Urgent Care Medicine (JUCM).
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