The Association of Brixia Scoring with the Clinical Severity and Need for Invasive Ventilation in Covid-19 Pneumonia Patients - A Prospective Cross-sectional Study

Abstract

Imaging is essential for managing COVID-19 pneumonia. In resource-limited settings, chest radiography is the only practicable imaging modality. The Brixia radiographic scoring system, an objective method of assessing pulmonary involvement, is yet to be studied in India. (a) To study the association between the clinical severity of COVID-19 patients with their Brixia scores and, (b) to evaluate the utility of the score as a predictor for invasive ventilation. Peripheral rural hospital by Indian Armed Forces; Cross-sectional study. A thousand patients diagnosed with COVID-19 and hospitalized were classified as having a mild, moderate, and severe disease based on their least oxygen saturation (SpO2 >94: mild, between 90-94: moderate, and <90: severe) recorded. The highest Brixia score was calculated for each patient. The mean Brixia scores of the three groups were compared. The Brixia score of each intubated patient was calculated as was the mean score of all intubated patients. Statistical analysis was performed on SPSS software. Seven hundred fifty-six (756) patients were classified as mild, 104 as moderate, and 140 as severe with a mean Brixia score of 0.12, 2.35, and 10.9, with a standard deviation of 0.66, 2.98, and 2.66, respectively. The difference in means between these groups was statistically significant (p < 0.0001). The median Brixia score of 13 for the intubated patients was significantly higher than for the non-intubated. The clinical severity of the patients and their requirement for invasive ventilation correlated well with their Brixia scores. The Brixia system may be usefully incorporated into our Medicare systems.

Keywords

• covid-19
• pneumonia
• radiography
• scoring system