Borghesi (2020)
Chest X-ray severity index as a predictor of in-hospital mortality in coronavirus disease 2019: A study of 302 patients from Italy
https://doi.org/10.1016/j.ijid.2020.05.021
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7207134/
Patient characteristics
Age (1 year increase vs. Not applicable)
COVID-19 (death)
Odds ratio: 1.081 (1.046-1.118) Adjusted model

Italy

Retrospective cohort study

Medical records

302

Through a retrospective search on the digital hospital archives between March 4, 2020 and March 24, 2020, all CXR reports including the new scoring system (the Brixia score) were retrieved. We enrolled only hospitalized 302 Caucasian patients with COVID-19 (confirmed by real-time polymerase chain reaction) for whom the final outcome (recovery or death) was available.

Patients with incomplete information about the presence of underlying comorbidities and immunosuppressive therapies were excluded from the study. For each included patient, only the CXR report with the highest score was considered for analysis. Each frontal chest projection linked to these reports was independently reviewed by a thoracic radiologist (A.B.), with 15 years’ experience of thoracic imaging, who reassigned the Brixia score. All chest X-rays were performed using portable digital radiography systems. Patient age, years 67.0 (57.0–77.0) Male 194 (64.2%)

Total

3 Week


COVID-19 (death)

65

death due to COVID-19


Patient characteristics

Age

Age (year)

Not applicable

1 year increase


Odds ratio

1.081 (1.046-1.118)

No

Yes

Yes

Risk was adjusted for CXR- Brixia score, age and immunosuppressive therapies


Brixia score is a new chest X-ray scoring system designed for COVID-19 pneumonia. This study demonstrated for the first time that a high Brixia score and at least one other predictive factor — patient age and conditions that induced immunosuppression — conferred the highest risk of death due to COVID-19.

Average

Yes