Mary M. Salvatore - April 15, 2020

Mary M. Salvatore, MD, MBA, "Chest Xray for triaging suspected COVID-19 patients"

Dr. Salvatore reported on findings that initial chest x-rays can help triage suspected COVID-19 patients in the ER. She went over how patients with COVID-19 present pathologically on scans, from ground glass opacities to full consolidation, where there is a lot of fluid in the lungs. From March 11 to the 26, NYP administered 1,256 chest x-rays for suspected COVID-19. This study looked at 410 of those x-rays and graded them based on the amount of consolidation in the lungs (normal = 1, 1/3-2/3 lung consolidated = 2, greater than 2/3 consolidation = 3). 55% percent of the x-rays were normal and tended to be from younger individuals. Of the patients that had normal chest x-rays, 74% of them were not tested for SARS-CoV-2 and 75% were discharged from the ED. They found that it was better to use the chest x-ray as a method for triaging compared to oxygen saturation levels since the chest x-ray is more sensitive since a patient may have 100% O2 but have fluid or opacities occurring on the x-ray. In summary, they found that patients with lower chest x-ray grade have shorter length of stay on average, patients with higher x-ray grade are more likely to get intubated, patients who are older tend to have higher x-ray grade, and older people have significantly higher risk of death.