Role of chest radiograph in MERS-Cov pneumonia: a single tertiary referral center experience in the United Arab Emirates
Egyptian Journal of Radiology and Nuclear Medicine · Volume 52, Issue 1 (2021)
Abstract
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Background</jats:title>
<jats:p>The Middle East respiratory syndrome coronavirus (MERS-Cov) continues to be a source of concern due to intermittent outbreaks. Serial chest radiographic changes in MERS-Cov patients were analyzed for various variables that could be compared to the patients’ final outcomes in a cluster of MERS-Cov patients and to identify a predictor of mortality in the United Arab Emirates.</jats:p>
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<jats:title>Results</jats:title>
<jats:p>A total of 44 MERS-Cov cases were reviewed. The mean age of the patients was 43.7 ± 14.7 years. The chest radiograph was abnormal in 14/44 (31.8%). The commonest radiology features include ground-glass opacities (seven of 14, 50%), ground-glass and consolidation (seven of 14, 50%), pleural effusion (eight of 14, 57.1%), and air bronchogram (three of 14, 21.4%). The mortality rate was 13.6% (six of 44); the deceased group (6 of 44, 13.6%) was associated with significantly higher incidence of mechanical ventilation (<jats:italic>p</jats:italic> < 0.001), pleural effusion (<jats:italic>p</jats:italic> < 0.001), chest radiographic score (8.90 ± 6.31, <jats:italic>p</jats:italic> < 0.001), and type 4 radiographic progression of disease (<jats:italic>p</jats:italic> < 0.001). A chest radiographic score at presentation was seen to be an independent and strong predictor of mortality (OR [95% confidence interval] 3.20 [1.35, 7.61]). The Cohen κ coefficient for the interobserver agreement was k = 0.89 (<jats:italic>p</jats:italic> = 0.001).</jats:p>
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<jats:title>Conclusion</jats:title>
<jats:p>The chest radiographic score, associated with a higher degree of disease progression (type 4), particularly in patients with old age or with comorbidity, may indicate a poorer prognosis in MERS-Cov infection, necessitating intensive care unit management or predicting impending death.</jats:p>
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