Özet:

Aim: To investigate the performance of chest X-ray (CXR) in distinguishing the patients who necessitate intensive care unit (ICU) admission among COVID-19 patients. Material and Methods: Between April to August 2020, 166 consecutive hospitalized COVID-19 patients who underwent acquisition of CXR within 24 hours of hospital admission were included in the study. Age, gender, number of comorbidities, smoking status and duration of symptoms for all patients were noted. Observer 1 interpreted the radiographic findings of CXRs of all patients. Distribution of radiographic findings were noted. Afterwards, Observer 1 and observer 2 assigned radiographic assessment of lung edema (RALE) score for each CXR independently. Sensitivity, specificity values in distinguishing COVID-19 patients who require ICU for each observer were calculated. Intraclass Correlation Coefficient (ICC) test was used to assess interobserver agreement levels. Results: Of the included patients, 128 (77.1%) patients were hospitalized only whereas 38 (22.9%) patients had necessity for ICU admission. Using 7.5 for RALE score as a cut-off point in distinguishing COVID-19 patients who need ICU admission Observer 1 had 89.5% and 93% for sensitivity and specificity, respectively; and Observer 2 had 89.5% and 91.4% for sensitivity and specificity, respectively. The ICC value for the interobserver agreement in RALE scores was 0.988 (95% confidence interval: 0.983 – 0.991). Conclusion: CXR can be helpful in distinguishing COVID-19 patients who necessitates ICU admission and a RALE score higher than 7.5 is indicative for ICU requirement.

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