Short Communication
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.2020.05.021Get rights and content
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Highlights

  • Brixia score is a new chest X-ray scoring system designed for COVID-19 pneumonia.

  • Brixia score, patient age and immunosuppressive conditions predict fatal outcome.

  • High Brixiascore and at least one other predictor confer the highest risk of death.

Abstract

Objectives

This study aimed to assess the usefulness of a new chest X-ray scoring system — the Brixia score — to predict the risk of in-hospital mortality in hospitalized patients with coronavirus disease 2019 (COVID-19).

Methods

Between March 4, 2020 and March 24, 2020, all CXR reports including the Brixia score were retrieved. We enrolled only hospitalized Caucasian patients with COVID-19 for whom the final outcome was available. For each patient, age, sex, underlying comorbidities, immunosuppressive therapies, and the CXR report containing the highest score were considered for analysis. These independent variables were analyzed using a multivariable logistic regression model to extract the predictive factors for in-hospital mortality.

Results

302 Caucasian patients who were hospitalized for COVID-19 were enrolled. In the multivariable logistic regression model, only Brixia score, patient age, and conditions that induced immunosuppression were the significant predictive factors for in-hospital mortality. According to receiver operating characteristic curve analyses, the optimal cutoff values for Brixia score and patient age were 8 points and 71 years, respectively. Three different models that included the Brixia score showed excellent predictive power.

Conclusions

Patients with a high Brixia score and at least one other predictive factor had the highest risk of in-hospital death.

Keywords

SARS-CoV-2
COVID-19
Chest X-ray
Scoring system

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