PT - JOURNAL ARTICLE AU - Mae Igi AU - Molly Lieux AU - Joe Park AU - Catherine Batte AU - Bradley Spieler TI - Coronavirus Disease (COVID-19): The Value of Chest Radiography for Patients Greater Than Age 50 Years at an Earlier Timepoint of Symptoms Compared With Younger Patients AID - 10.31486/toj.20.0102 DP - 2021 Jun 20 TA - Ochsner Journal PG - 126--132 VI - 21 IP - 2 4099 - http://www.ochsnerjournal.org/content/21/2/126.short 4100 - http://www.ochsnerjournal.org/content/21/2/126.full SO - Ochsner J2021 Jun 20; 21 AB - Background: A relative paucity of data exists regarding chest radiography (CXR) in diagnosis of coronavirus disease (COVID-19) compared to computed tomography. We address the use of a strict pattern of CXR findings for COVID-19 diagnosis, specifically during early onset of symptoms with respect to patient age.Methods: We performed a retrospective study of patients under investigation for COVID-19 who presented to the emergency department during the COVID-19 outbreak of 2020 and had CXR within 1 week of symptoms. Only reverse transcription polymerase chain reaction (RT-PCR)–positive patients were included. Two board-certified radiologists, blinded to RT-PCR results, assessed 60 CXRs in consensus and assigned 1 of 3 patterns: characteristic, atypical, or negative. Atypical patterns were subdivided into more suspicious or less suspicious for COVID-19.Results: Sixty patients were included: 30 patients aged 52 to 88 years and 30 patients aged 19 to 48 years. Ninety-three percent of the older group demonstrated an abnormal CXR and were more likely to have characteristic and atypical–more suspicious findings in the first week after symptom onset than the younger group. The relationship between age and CXR findings was statistically significant (χ2 [2, n=60]=15.70; P=0.00039). The relationship between negative and characteristic COVID-19 CXR findings between the 2 age cohorts was statistically significant with Fisher exact test resulting in a P value of 0.001.Conclusion: COVID-19 positive patients >50 years show earlier, characteristic patterns of statistically significant CXR changes than younger patients, suggesting that CXR is useful in the early diagnosis of infection. CXR can be useful in early diagnosis of COVID-19 in patients older than 50 years.