Determining COVID-19 disease severity and outcome using sequential chest radiograph in a new designated COVID-19 hospital

Munirathnam, Mahendra; Mohan, CN; Mohammadi, Javeriya; Gowda, Samarth S.; Ramaiah, Madhumati

doi:10.18203/2349-3933.ijam20205480

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…Our study shows a significant difference between the patient's Brixia Score with D-Dimer <2 µg/mL and D Dimer ≥2 µg/mL with a p<0.001 (p<0.05) which means there is a relationship between Brixia Score and D-Dimer. This is in line with other studies that there is a significant relationship between Brixia Score with D-Dimer levels in patients, where a higher D-Dimer level is accompanied by a higher Brixia Score (Munirathnam et al, 2020;Viradanti and Kusmala, 2021;Garg et al, 2022). Some previous research reports that most COVID-19 patients have elevated D-Dimer levels due to excessive inflammatory response of lung parenchymal cells and edothelial cells in the lung blood vessels that causes dysregulation in the coagulation system.…”

Section: Sample Characteristicssupporting

confidence: 91%

Brixia Score as Predictor of D-Dimer Levels of COVID-19 Patients in Intensive Care Unit

Adyanata

Soewondo²,

Arifin³

et al. 2023

INDONES J MED

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Background: COVID-19 is caused by a novel virus that can cause lung abnormalities which can be measured with new chest x-ray scoring system named Brixia score. In COVID-19 patients, coagulation disorders are often found that can be seen through D-Dimer levels. This study aimed to prove the Brixia Score as a predictor of D-Dimer levels. Subjects and Method: This study was an observational analytic study with a cross-sectional approach. The subjects were 94 COVID-19 patients which taken from ICU Melati 1 Dr. Moewardi General Hospital, Surakarta from March 2021 to August 2021 who met the exclusion and inclusion criteria. The independent variable is Brixia score performed by radiologists and dependent variable is D-Dimer levels taken from laboratory results. Sampling was obtained by purposive sampling and the data were investigated using the receiver operating characteristic (ROC) curve. Results: 94 samples were obtained for analysis. The average Brixia Score of patients with D-Dimer <2 µg/mL was Mean= 15.85; SD= 1.43 and D-Dimer ≥2 µg/mL was Mean= 17.29; SD= 0.96. There was a significant difference between the Brixia Score of patients with D-Dimer <2 µg/mL and D-Dimer ≥2 µg/mL (p<0.001). Analysis with the ROC curve shows an area under the curve (AUC) of 0.793. The optimal cutoff value of the Brixia Score for predicting D-Dimer levels was 16.5 (sensitivity 77.9%, specificity 73.1%). Conclusion: Brixia Score proved to be a predictor of D-Dimer levels of COVID-19 patients in ICU care.

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Section: Sample Characteristicssupporting

confidence: 91%

Brixia Score as Predictor of D-Dimer Levels of COVID-19 Patients in Intensive Care Unit

Adyanata

Soewondo²,

Arifin³

et al. 2023

INDONES J MED

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“…Our study confirms the main radiological characteristics of COVID-19 described in previous studies. BRIXIA score was significantly higher in patients with severe clinical disease presentation (59,8% high-very high mortality score), which has also been showcased in similar studies [9][10][11][12]. In addition, a lower RALE score was associated with better oxygenation as reflected by higher PaO2/FiO2.…”

Section: Discussionsupporting

confidence: 72%

Evaluation of Reliability and Validity of the RALE and BRIXIA Chest-X Ray Scores in Patients Hospitalized with COVID-19 Pneumonia

Paraskevas,

Dimopoulos,

Kantanis

et al. 2023

Romanian Journal of Internal Medicine

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Introduction: Chest X-rays are commonly used to assess the severity in patients that present in the emergency department with suspected COVID-19 pneumonia, but in clinical practice quantitative scales are rarely employed. Aims: To evaluate the reliability and validity of two semi-quantitative radiological scales in patients hospitalized for COVID-19 pneumonia (BRIXIA score and RALE score). Methods: Patients hospitalized between October 2021 and March 2022 with confirmed COVID-19 pneumonia diagnosis were eligible for inclusion. All included patients had a chest X-ray taken in the ED before admission. Three raters that participated in the treatment and management of patients with COVID-19 during the pandemic independently assessed chest X-rays. Results: Intraclass coefficients for BRIXΙA and RALES was 0.781 (0.729-0.826) and 0.825 (0.781-0.862) respectively, showing good to excellent reliability overall. Pairwise analysis was performed using quadratic weighted kappa showing significant variability in the inter-rater agreement. The prognostic accuracy of the two scores for in-hospital mortality for all raters was between 0.753 and 0.763 for BRIXIA and 0.737 and 0.790 for RALES, demonstrating good to excellent prognostic value. Both radiological scores were significantly associated with inhospital mortality after adjustment for 4C Mortality score. We found a consistent upwards trend with significant differences between severity groups in both radiological scores. Conclusion: Our findings suggest that BRIXIA and RALES are reliable and can be used to assess the prognosis of patients with COVID-19 requiring hospitalization. However, the inherent subjectivity of radiological scores might make it difficult to set a cut-off value suitable for all assessors.

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“…The study results conducted by Setiawati et al, 18 Maroldi et al, 19 and Munirathnam et al 20 showed that the Brixia score correlated significantly with the severity of COVID-19 patients clinically. Maroldi et al 19 and Munirathnam et al 20 also found that Brixia scores were external predictors of hospitalized COVID-19 patients, whether surviving or dying.…”

Section: Discussionmentioning

confidence: 93%

Brixia Score for Predicting Mortality and Length of Stay in COVID-19 Confirmed Patients at the Hospital in Bandung

Setiapriagung

Tresnasari

Yulianto

2022

Glob Med Health Commun

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On March 11, 2020, the World Health Organization declared the COVID-19 pandemic. This disease damages the lung and resulting mild to severe pneumonia. This study aimed to determine the value of the Brixia score for predicting mortality and length of stay of COVID-19 confirmed patients. The study design was case-control with secondary data from digital medical records of COVID-19 confirmed patients (December 2020 to February 2021). All patients' chest x-rays (CXR) were scored using the Brixia score. Logistic regression and the Spearman rank correlation test were used to identify mortality and length of stay predictors. There were 636 subjects included in this study, with the proportion of deceased patients (case group) being 20.3% (95% CI=17.33, 23.59%). Most CXR findings had signs of pneumonia (95.1%), including ground-glass opacities (GGOs) mixed with consolidation. The distribution of GGOs and consolidation were most frequent in the peripheral of survived patients (83.9%), while the deceased group had peripheral involvements mixed with medial (45.0%) and bilateral (22.2%). The mean Brixia score in the group of decease patients was significantly higher than the group of survived patients (11.95 vs 6.73, p=0.00). Brixia score had an OR of 1.14, 95% CI=1.07, 1.21 after adjusting by age, SpO2 level, and comorbid. The chance of dying was higher than 50% if the Brixia score reached to score of 15 (probability=49%, 95% CI=41, 56%). However, the Brixia score has no significant correlation with length of stay (rho=0.05, p=0.24). In conclusion, the CXR Brixia score can predict mortality, but it can not predict the length of stay of hospitalized COVID-19 confirmed patients.

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Determining COVID-19 disease severity and outcome using sequential chest radiograph in a new designated COVID-19 hospital

Cited by 4 publications

References 9 publications

Brixia Score as Predictor of D-Dimer Levels of COVID-19 Patients in Intensive Care Unit

Brixia Score as Predictor of D-Dimer Levels of COVID-19 Patients in Intensive Care Unit

Evaluation of Reliability and Validity of the RALE and BRIXIA Chest-X Ray Scores in Patients Hospitalized with COVID-19 Pneumonia

Brixia Score for Predicting Mortality and Length of Stay in COVID-19 Confirmed Patients at the Hospital in Bandung

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