Chest radiography or computed tomography for COVID-19 pneumonia? Comparative study in a simulated triage setting

Abstract

Interobserver agreement was fair (Kendall's <i>W</i>=0.365, p<0.001) by the reconstructed chest radiography-based protocol and good (Kendall's <i>W</i>=0.654, p<0.001) by the CT-based protocol. NPV assisted by reconstructed chest radiography (31.4%) was lower than that of HRCT (77.9%). In case of indeterminate or typical radiological appearance for COVID-19 pneumonia, extent of disease on reconstructed chest radiography or HRCT were the only two imaging variables that were similarly linked to mortality by adjusted multivariable models CONCLUSIONS: The present findings suggest that clinical triage is safely assisted by chest radiography. An integrated algorithm using first-line chest radiography and contingent use of HRCT can help optimise management and prognostication of COVID-19.