Brixia score on initial chest X-ray as a predictor of outcome in COVID-19 and H1N1 acute chest infections: A retrospective study.

This study aims to evaluate the use of the Brixia score on chest X-ray to predict disease severity, progression, and outcomes across 2 distinct viral infections: COVID-19 and H1N1. A retrospective analysis was conducted on patients diagnosed with COVID-19 (March 1, 2020-January 1, 2021) and H1N1 (January 1, 2016-January 1, 2021) at a tertiary hospital. Chest X-rays obtained within 24 hours of presentation were scored using the Brixia score (score at admission) by 2 board-eligible radiology residents. Scoring of subsequent images was also performed to assess disease progression by documenting the highest score, lowest score, and score at death or discharge. This study included 953 COVID-19 patients and 222 H1N1 patients. The number of male cases was predominant in both COVID-19 (56.5%) and H1N1 (53.2%). The median age was higher in COVID-19 patients (60 years) compared to HIN1 patients (40 years) (P < .001). COVID-19 patients had a higher mortality rate and greater severity as depicted by Brixia scores at the time of admission (8.35 vs 6.77) and at discharge/death (12.64 vs 12.33; P < .001). Hypertension was the most common comorbidity in COVID-19 patients (57.3%) and HN1 patients (26.1%) (P < .001). Our study demonstrates the prognostic value of the Brixia score in predicting outcomes across COVID-19 and H1N1 patients. COVID-19 patients had higher Brixia scores and greater score increments over time, correlating with increased mortality. These findings demonstrate the role of chest radiographic assessment in early risk determination and clinical decision-making.