Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory
syndrome coronavirus 2 and was declared a global pandemic by the World Health
Organization on 11 March 2020. A definitive diagnosis of COVID-19 is made after
a positive result is obtained on reverse transcription-polymerase chain reaction
assay. In Singapore, rigorous contact tracing was practised to contain the spread
of the virus. Nasal swabs and chest radiographs (CXR) were also taken from
individuals who were suspected to be infected by COVID-19 upon their arrival at
a centralised screening centre. From our experience, about 40% of patients who
tested positive for COVID-19 had initial CXR that appeared “normal”. In this
case series, we described the temporal evolution of COVID-19 in patients with an
initial “normal” CXR. Since CXR has limited sensitivity and specificity in
COVID-19, it is not suitable as a first-line diagnostic tool. However, when CXR
changes become unequivocally abnormal, close monitoring is recommended to
manage potentially severe COVID-19 pneumonia.
Key words: Diagnostic Radiology, Infectious Diseases, Pulmonary
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