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dc.contributor.authorOng, Sean Wei Xiangen_US
dc.contributor.authorHui, Terrence Chi Hongen_US
dc.contributor.authorLee, Yeong Shyanen_US
dc.contributor.authorHaja Mohideen, Salahudeen Mohameden_US
dc.contributor.authorYoung, Barnaby Edwarden_US
dc.contributor.authorTan, Cher Hengen_US
dc.contributor.authorLye, David Chien Boonen_US
dc.identifier.citationOng, S. W. X., Hui, T. C. H., Lee, Y. S., Haja Mohideen, S. M., Young, B. E., Tan, C. H. & Lye, D. C. B. (2021). High-risk chest radiographic features associated with COVID-19 disease severity. PloS ONE, 16(1), e0245518-.
dc.description.abstractObjectives: High-risk CXR features in COVID-19 are not clearly defined. We aimed to identify CXR features that correlate with severe COVID-19. Methods: All confirmed COVID-19 patients admitted within the study period were screened. Those with suboptimal baseline CXR were excluded. CXRs were reviewed by three independent radiologists and opacities recorded according to zones and laterality. The primary endpoint was defined as hypoxia requiring supplemental oxygen, and CXR features were assessed for association with this endpoint to identify high-risk features. These features were then used to define criteria for a high-risk CXR, and clinical features and outcomes of patients with and without baseline high-risk CXR were compared using logistic regression analysis. Results: 109 patients were included. In the initial analysis of 40 patients (36.7%) with abnormal baseline CXR, presence of bilateral opacities, multifocal opacities, or any upper or middle zone opacity were associated with supplemental oxygen requirement. Of the entire cohort, 29 patients (26.6%) had a baseline CXR with at least one of these features. Having a high-risk baseline CXR was significantly associated with requiring supplemental oxygen in univariate (odds ratio 14.0, 95% confidence interval 3.90–55.60) and multivariate (adjusted odds ratio 8.38, 95% CI 2.43–28.97, P = 0.001) analyses. Conclusion: We identified several high-risk CXR features that are significantly associated with severe illness. The association of upper or middle zone opacities with severe illness has not been previously emphasized. Recognition of these specific high-risk CXR features is important to prioritize limited healthcare resources for sicker patients.en_US
dc.description.sponsorshipNational Medical Research Council (NMRC)en_US
dc.relation.ispartofPloS ONEen_US
dc.rights© 2021 Ong et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_US
dc.titleHigh-risk chest radiographic features associated with COVID-19 disease severityen_US
dc.typeJournal Articleen
dc.contributor.schoolLee Kong Chian School of Medicine (LKCMedicine)en_US
dc.contributor.organizationNational Centre for Infectious Diseasesen_US
dc.contributor.organizationTan Tock Seng Hospitalen_US
dc.description.versionPublished versionen_US
dc.description.acknowledgementThis study was funded by the NMRC COVID-19 Research Fund (COVID19RF-001). The funding sources had no role in study design, data analysis and collection, interpretation of results, or decision to submit the paper for publication.en_US
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