Discordance Between Clinical Status and Chest X-Ray (CXR) in COVID-19 Patient with Asymptomatic Transmission in Jakarta

Erlina Burhan, Heidy Agustin, Agus Dwi Susanto, Ibrahim Nur Insan Putra Dharmawan, Markus Meyer, Rita Rogayah

Abstract


Coronavirus Disease 2019 (COVID-19) symptoms are highly various in each patient. CXR are routinely used to monitor the disease progression. However, it is not known whether chest X-Ray (CXR) is a good modality to assess COVID-19 pneumonia.

Male, 55 years-old, with pneumonia caused by COVID-19. Discordance was found between patient’s clinical status and CXR lesion. On the 7th day of symptoms, patient was clinically well despite severe lesion shown on CXR. On the following day, patient clinically deteriorated despite the improvement on CXR lesion.

Improvement of CXR does not always correlate well with patient’s clinical status. Clinician have to be careful when using CXR to monitor patient with COVID-19 pneumonia.


Keywords


COVID-19; chest X-ray; asymptomatic transmission

References


Q&A on coronaviruses (COVID-19) [Internet]. [cited 2020 Apr 3]. Available from: https://www.who.int/news-room/q-a-detail/q-a-coronaviruses.

Ye F, Xu S, Rong Z, et al. Delivery of infection from asymptomatic carriers of COVID-19 in a familial cluster. Int J Infect Dis. 2020 May;94:133–8.

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Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020;19:1–9.


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