Rama Co-RADS: Cutting-edge tool for improved communication in management and treatment of COVID-19 patients in Thailand

Thitiporn Suwatanapongched; Chayanin Nitiwarangkul; Vanlapa Arnuntasupakul; Sasisopin Kiertiburanakul

doi:10.46475/aseanjr.v22i2.144

Authors

Thitiporn Suwatanapongched, M.D. Division of Diagnostic Radiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Chayanin Nitiwarangkul, M.D. Division of Diagnostic Radiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Vanlapa Arnuntasupakul, M.D. Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Sasisopin Kiertiburanakul, M.D. Division of Infectious Disease, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

DOI:

https://doi.org/10.46475/aseanjr.v22i2.144

Keywords:

SAR-CoV-2, COVID-19, Chest X-ray, Chest radiograph, Report, Alternative healthcare facilities

Abstract

In Thailand, the rapid and constant rise in the number of confirmed COVID-19 cases, together with the increasing number of patients requiring respiratory and other medical life support during the third wave of COVID-19, has drastically overwhelmed the existing country’s healthcare facilities, physicians, and other healthcare workers. Hence, early identification of vulnerable patients at risk and early COVID-19 pneumonia is crucial for timely management and treatment by antivirals or corticosteroids to prevent them from developing severe COVID-19 pneumonia. A prompt chest X-ray report with clear and concise information at baseline screening in alternative healthcare facilities, especially in resource-constrained conditions, is essential. The article presents the incorporation of Rama Co-RADS (a categorical assessment scheme for chest X-ray findings for diagnosing pneumonia in patients with confirmed COVID-19). Its use facilitates a rapid, clear, and concise X-ray report despite the various levels of radiologists’ experience. Comprehensibleand consistent chest X-ray information successfully reduces the time lapse and communication gap among medical staff and assists on-duty, frontline physicians to make prompt and more accurate decisions regarding the management and treatment of COVID-19 patients in accordance with the current national guideline.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Nittayasoot N, Suphanchaimat R, Namwat C, Dejburum P, Tangcharoensathien V. Public health policies and health-care workers' response to the COVID-19 pandemic, Thailand. Bull World Health Organ. 202199:312-8. doi: 10.2471/BLT.20.275818.

Beyrampour-Basmenj H, Milani M, Ebrahimi-Kalan A, Ben Taleb Z, Ward KD, Dargahi Abbasabad G, et al. An Overview of the Epidemiologic, Diagnostic and Treatment Approaches of COVID-19: What do we know? Public Health Rev 2021;42:1604061. doi: 10.3389/phrs.2021.1604061.

Department of Disease Control, Ministry of Public Health [Internet]. Nonthaburi: MOPH; c2021 [cited 2021 July 31]. [Coronavirus Disease (COVID-19): Thailand situation].. Available from: https://ddc.moph.go.th/viralpneumonia/index.php. Thai.

Booth A, Reed AB, Ponzo S, Yassaee A, Aral M, Plans D, et al. Population risk factors for severe disease and mortality in COVID-19: a global systematic review and meta-analysis. PLoS ONE 2021;16:e0247461. doi.org/10.1371/journal.pone.0247461.

Kaleemi R, Hilal K, Arshad A, Martins RS, Nankani A, Tu H, et al. The association of chest radiographic findings and severity scoring with clinical outcomes in patients with COVID-19 presenting to the emergency department of a tertiary care hospital in Pakistan. PLoS One 2021;16:e0244886. doi: 10.1371/journal.pone.0244886.

Angus DC, Derde L, Al-Beidh F, Annane D, Arabi Y, Beane A, et al. Effect of hydrocortisone on mortality and organ support in patients with severe COVID-19: the REMAP-CAP COVID-19 corticosteroid domain randomized clinical trial. JAMA 2020;324:1317-29. doi:10.1001/jama.2020.17022.

Department of Medical Services, Ministry of Public Health [Internet]. Nonthaburi: MOPH; c2019 [cited 2021 July 31]. [COVID-19]. Available from: https://covid19.dms.go.th. Thai.

Department of Medical Services, Ministry of Public Health. [Guidelines on the management of hospitels for COVID-19 patients with mild disease and no or controlled co morbidities] [Internet]. Nonthaburi: MOPH; 2021 July 20 [cited 2021 July 30]. Available from: https://bit.ly/3icP0yx. Thai.

Department of Medical Services, Ministry of Public Health. [Guidelines on the establishment of hospitels for COVID-19 [Internet]. Nonthaburi: MOPH; 2020 March 3 [cited 2021 July 30]. . Available from: https://bit.ly/3rLOr26.

Department of Disease Control, Ministry of Public Health. [Guidelines on the establishment of field hospitals in case of COVID-19 widespread] [Internet]. Nonthaburi: MOPH; 2021 January 7 [cited 2021 July 2]. Available from: https://covid19.dms.go.th/backend/Content/Content_File/Covid_Health/Attach/25640111082302AM_Field%20Hospital%20GL_V_5_08012021.pdf. Thai.

Prutipinyo C. COVID-19 field hospital: alternative state quarantine hospital and hospitel. Public Health Policy & Laws Journal 2021;7(1):195-213.

Department of Medical Services, Ministry of Public Health. [Guidelines on clinical practice, diagnosis, treatment, and prevention of healthcare-associated infection for COVID-19] [Internet]. Nonthaburi; MOPH; . [updated 2021 July 21; cited 2021 July 29]. Available from: https://covid19.dms.go.th/backend/Content/Content_File/Covid_Health/Attach/25640721115923AM_CPG_COVID_v.16.4.n.pdf. Thai.

Meng H, Xiong R, He R, Lin W, Hao B, Zhang L, et al. CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China. J Infect 2020;81:e33-9. doi: 10.1016/j.jinf.2020.04.004.

Wang Y, Dong C, Hu Y, Li C, Ren Q, Zhang X, et al. Temporal changes of CT findings in 90 patients with COVID-19 pneumonia: a longitudinal study. Radiology 2020;296:E55-64. doi: 10.1148/radiol.2020200843.

Litmanovich DE, Chung M, Kirkbride RR, Kicska G, Kanne JP. Review of chest radiograph findings of COVID-19 pneumonia and suggested reporting language. J Thorac Imaging 2020;35:354-60. doi: 10.1097/RTI.0000000000000541.

Rodrigues JCL, Hare SS, Edey A, Devaraj A, Jacob J, Johnstone A, et al. An update on COVID-19 for the radiologist - A British society of Thoracic Imaging statement. Clin Radiol 2020;75:323-5. doi: 10.1016/j.crad.2020.03.003.

Rubin GD, Ryerson CJ, Haramati LB, Sverzellati N, Kanne JP, Raoof S, et al. The role of chest imaging in patient management during the COVID-19 pandemic: a multinational consensus statement from the Fleischner Society. Radiology 2020;296:172-80. doi: 10.1148/radiol.2020201365.

Kwee TC, Kwee RM. Chest CT in COVID-19: What the radiologist needs to know. Radiographics 2020;40:1848-65. doi:10.1148/rg.2020200159.

Kohli A, Hande PC, Chugh S. Role of chest radiography in the management of COVID-19 pneumonia: An overview and correlation with pathophysiologic changes. Indian J Radiol Imaging 2021;31(Suppl 1):S70-9. doi: 10.4103/ijri.IJRI_967_20.

Goyal A, Tiwari R, Bagarhatta M, Ashwini B, Rathi B, Bhandari S. Role of portable chest radiography in management of COVID-19: Experience of 422 patients from a tertiary care center in India. Indian J Radiol Imaging 2021;31(Suppl 1):S94-100. doi: 10.4103/ijri.IJRI_480_20.

Gross A, Heine G, Schwarz M, Thiemig D, Gläser S, Albrecht T. Structured reporting of chest CT provides high sensitivity and specificity for early diagnosis of COVID-19 in a clinical routine setting. Br J Radiol 2021;94(1117):20200574. doi: 10.1259/bjr.20200574.

Stanzione A, Ponsiglione A, Cuocolo R, Rumolo M, Santarsiere M, Scotto R, et al. Chest CT in COVID-19 patients: structured vs conventional reporting. Eur J Radiol 2021;138:109621. doi: 10.1016/j.ejrad.2021.109621.

Kwee RM, Adams HJA, Kwee TC. Diagnostic Performance of CO-RADS and the RSNA classification system in evaluating COVID-19 at Chest CT: A Meta-Analysis. Radiol Cardiothorac Imaging 2021;3:e200510. doi: 10.1148/ryct.2021200510.

Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M, et al. Radiological Society of North America Expert Consensus Statement on reporting chest CT findings related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA - Secondary Publication. J Thorac Imaging 2020;35:219-27. doi: 10.1097/RTI.0000000000000524.

Prokop M, van Everdingen W, van Rees Vellinga T, Quarles van Ufford H, Stöger L, et al. COVID-19 standardized reporting working group of the Dutch Radiological Society. CO-RADS: a categorical CT assessment scheme for patients suspected of having COVID-19-definition and evaluation. Radiology 2020;296:E97-104. doi: 10.1148/radiol.2020201473.

Yates A, Dempsey PJ, Vencken S, MacMahon PJ, Hutchinson BD. Structured reporting in portable chest radiographs: An essential tool in the diagnosis of COVID-19. Eur J Radiol 2021;134:109414. doi:10.1016/j.ejrad.2020.109414.

De Sanctis V, Bedair EMA, Soliman AT, Nair AP, Al Masalamani MA, Yassin M. Proposed scoring system for evaluating clinico-radiological severity of COVID-19 using plain chest x-ray (CXR) changes (CO X-RADS): preliminary results. Acta Biomed 2020;91:e2020172. doi:10.23750/abm.v91i4.10664.

Suwatanapongched T, Nitiwarangkul C, Sukkasem W, Phongkitkarun S. Rama Co-RADS: categorical assessment scheme of chest radiographic findings for diagnosing pneumonia in patients with confirmed COVID-19. Rama Med J 2021:44(2):50-62. doi.org/10.33165/rmj.2021.44.2.251259. Thai.

Yoon SH, Lee KH, Kim JY, Lee YK, Ko H, Kim KH, et al. Chest radiographic and CT findings of the 2019 novel coronavirus disease (COVID-19): analysis of nine patients treated in Korea. Korean J Radiol 2020;21:494-500. doi:10.3348/kjr.2020.0132.

Wong HYF, Lam HYS, Fong AH, Leung ST, Chin TW, Lo CSY, et al. Frequency and distribution of chest radiographic findings in patients positive for COVID-19. Radiology 2020;296(2):E72-8. doi: 10.1148/radiol.2020201160.

R8way, Ministry of Public Health [Internet]. Nonthaburi: MOPH; 2021 [cited 2021 July 30].Case management COVID-19. Available from: https://r8way.moph.go.th/r8way/covid-19.

Tanomkiat W, Taprig A, Piyavisetpat N. RadioVolunteer, the novel combination of social, management and technological innovations in radiological societies of Thailand during Covid-19 pandermic. Asean J Radiol. In press 2021.