Analysis of Characteristics of Bedside Chest Radiography in Critically Ill COVID-19 Patients

Objective: To analyze the characteristics of bedside chest radiography in critically ill COVID-19 patients.Methods: Bedside chest x-ray data of 8 severe cases with COVID-19 during hospitalization were collected consecutively. The disease was divided into three stages, including early stage (1-4 days), progression stage (5-10 days), and recovery stage(≥11 days). Two radiologists individually analyzed the chest radiographs by a double-blind method and compared the changes of the distribution, morphology, and boundary of the pulmonary lesions, as well as mediastinum and heart shadow of different disease stages.Results: Among these cases, 1 case was in the early stage, 6 cases were in the progressive stage, and 1 case was in the recovery stage. A total of 68 bedside chest radiographs were obtained. In early stage, lesions were mainly in the external zone of both lungs with increased lamellar density. In progression stage, the lesions involved multiple pulmonary segments and lobes with extensive infiltrating changes. The heart shadow was mildly to moderately enlarged. In recovery stage, the broad distribution of striated density increased in both lungs, and the heart shadow remained enlarged.Conclusions: The pulmonary lesions in critically ill COVID-19 patients were characterized by rapid progression, extensive distribution, varied manifestations, and possible concomitant cardiac dilatation. Bedside chest radiograph examination could provide certain significance in the follow-up of critically ill patients.