PMID- 33289614 OWN - NLM STAT- MEDLINE DCOM- 20210310 LR - 20210310 IS - 1527-1315 (Electronic) IS - 0033-8419 (Print) IS - 0033-8419 (Linking) VI - 298 IP - 3 DP - 2021 Mar TI - Utility of Screening Chest Radiographs in Patients with Asymptomatic or Minimally Symptomatic COVID-19 in Singapore. PG - E131-E140 LID - 10.1148/radiol.2020203496 [doi] LID - 203496 AB - Background Singapore saw an escalation of coronavirus disease 2019 (COVID-19) cases from fewer than 4000 in April 2020 to more than 40 000 in June 2020, with most of these cases attributed to spread within shared facilities housing foreign workers. Appropriate triage and escalation of clinical care are crucial for this patient group managed in community care facilities (CCFs). Purpose To evaluate the imaging guideline recommendations for COVID-19 from the Fleischner Society and to analyze the clinical utility of screening chest radiography for asymptomatic or minimally symptomatic patients with COVID-19. Materials and Methods In this retrospective study, patients with reverse-transcription polymerase chain reaction-confirmed COVID-19 who were admitted to a designated CCF for continuation of their treatment during May 3-31, 2020, were identified. Upon admission, patients aged 36 years and older without any baseline chest images underwent chest radiography. All chest radiographs and clinical outcomes of patients, including those who were subsequently transferred to acute hospitals for escalation of care, were reviewed. Key proportions of patients with findings of pulmonary infection and those requiring further inpatient treatment were calculated, and 95% binomial proportion CIs were obtained using the Clopper-Pearson method. Results The study included 5621 patients. All patients were men (100%; 5621 of 5621), and the mean patient age was 37 years +/- 8 (range, 17-60 years). A total of 1964 chest radiographs were obtained, of which normal images accounted for 98.0% (1925 of 1964 radiographs) and findings of pulmonary infection represented 2.0% (39 of 1964 radiographs). Only 0.2% of patients (four of 1964) with findings of pulmonary infection at chest radiography (all of whom were symptomatic) required supplemental oxygenation and inpatient treatment. None of the asymptomatic patients with findings of pulmonary infection required supplemental oxygenation, and they received only symptomatic treatment. Conclusion In accordance with Fleischner Society recommendations, screening chest radiography is not indicated in patients with coronavirus disease 2019 who are aged 17-60 years with mild or no symptoms unless there is risk of clinical deterioration. (c) RSNA, 2021 See also the editorial by Schaefer-Prokop and Prokop in this issue. FAU - Kuo, Benjamin J AU - Kuo BJ AUID- ORCID: 0000-0002-3074-2123 AD - From the Department of Diagnostic Radiology, Division of Radiological Sciences (B.J.K., Y.K.L.), and Department of Nuclear Medicine and Molecular Imaging (X.Y.C.G.), Singapore General Hospital, 20 College Rd, Singapore 169608; SATA CommHealth, Singapore, Singapore (M.L.M.T.). FAU - Lai, Yusheng Keefe AU - Lai YK AUID- ORCID: 0000-0002-5752-4273 AD - From the Department of Diagnostic Radiology, Division of Radiological Sciences (B.J.K., Y.K.L.), and Department of Nuclear Medicine and Molecular Imaging (X.Y.C.G.), Singapore General Hospital, 20 College Rd, Singapore 169608; SATA CommHealth, Singapore, Singapore (M.L.M.T.). FAU - Tan, Ming Loong Mark AU - Tan MLM AUID- ORCID: 0000-0003-3316-5285 AD - From the Department of Diagnostic Radiology, Division of Radiological Sciences (B.J.K., Y.K.L.), and Department of Nuclear Medicine and Molecular Imaging (X.Y.C.G.), Singapore General Hospital, 20 College Rd, Singapore 169608; SATA CommHealth, Singapore, Singapore (M.L.M.T.). FAU - Goh, Xian-Yang Charles AU - Goh XC AUID- ORCID: 0000-0002-2962-7371 AD - From the Department of Diagnostic Radiology, Division of Radiological Sciences (B.J.K., Y.K.L.), and Department of Nuclear Medicine and Molecular Imaging (X.Y.C.G.), Singapore General Hospital, 20 College Rd, Singapore 169608; SATA CommHealth, Singapore, Singapore (M.L.M.T.). LA - eng PT - Journal Article DEP - 20201208 PL - United States TA - Radiology JT - Radiology JID - 0401260 SB - IM CIN - Radiology. 2020 Dec 8;:204038. PMID: 33290177 MH - Adolescent MH - Adult MH - COVID-19/*diagnostic imaging MH - Female MH - Humans MH - Lung/*diagnostic imaging MH - Male MH - Middle Aged MH - Radiography/*methods MH - Reproducibility of Results MH - Retrospective Studies MH - SARS-CoV-2 MH - Severity of Illness Index MH - Singapore MH - Young Adult PMC - PMC7734843 EDAT- 2020/12/09 06:00 MHDA- 2021/03/11 06:00 PMCR- 2020/12/14 CRDT- 2020/12/08 12:16 PHST- 2020/12/09 06:00 [pubmed] PHST- 2021/03/11 06:00 [medline] PHST- 2020/12/08 12:16 [entrez] PHST- 2020/12/14 00:00 [pmc-release] AID - 10.1148/radiol.2020203496 [doi] PST - ppublish SO - Radiology. 2021 Mar;298(3):E131-E140. doi: 10.1148/radiol.2020203496. Epub 2020 Dec 8.