Abstract:

Background: An outbreak of severe cases of pneumonia from an unidentified origin emerged in Wuhan, China in December, 2019. The illness rapidly spread in China and in many other countries. In January 2020, the World Health Organization (WHO) declared it a pandemic. A virus was identified and isolated from the epithelial cells of the respiratory system of infected individuals and was named as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the outbreak was named coronavirus disease (COVID-19). COVID-19 primary affect the lung but can also affect other system, CXR appear to be an important tool in evaluation of the disease in terms of diagnosis and to monitor disease progression. several severity scoring system were introduced by different hospitals and scientists to facilitate decision making in terms of hospitalization, prioritization, the type of management and the clinical outcome for the patients but Several studies have shown the Modified brixia X-ray Score to be a reliable tool for assessing the severity of lung involvement in patients with COVID-19 pneumonia. However previous evaluation of modified brixia score has not done in our country therefore it is important to have a baseline modified brixia score at admission to predict COVID-19 patient treatment outcomes and help to develop a scientific algorithm on routine screening strategies at admission. The fact that modified brixia score use CXR which is cheap, simple, fast and safe modality it will be useful in resource limited countries.

Objectives: To determine the association of the baseline modified brixia scoring system and outcomes among patients with COVID-19 pneumonia at Bugando Medical Centre.

Methodology: This was a hospital-based retrospective cohort study, which was conducted at Bugando Medical Centre in Mwanza, Tanzania. The study enrolled 220 adult patients who tested positive for SARS-COV-2 confirmed by RT-PCR assay of nasopharyngeal swab from
September 2021 – 31st May 2022. We used the CXR which were taken during admission and baseline modified brixia score was associated with COVID-19 patients’ outcomes (disease severity, mortality and length of hospital stay). Data was analysed using STATA software version 15 according to the objectives of the study.

Result; Of the 220 patients enrolled; the mean age was 59 (SD ±12.42) years, and males patients were 121 (55%). The overall median (IQR) length of the hospital stay was 9 [6-13] days, and in-hospital mortality was 30.9% (68/220). The results showed that there was a statistically significant association of Brixia scores greater than (p value 0.041, OR = 5.39) with in-hospital mortality and COVID-19 severity (p value = 0.001, OR = 4.80)..


Conclusion
Modified Brixia score correlates strongly with disease severity and mortality; it may support the clinical decision-making, particularly in patients with moderate to severe signs and symptoms. The modified Brixia score should be incorporated in a prognostic model, which would be desirable, particularly in resource-constraint scenarios.