INTRODUCTION On the frontlines of fighting the COVID-19 pandemic, chest imaging serves as an indispensable tool in the assessment of disease severity, monitoring the disease progression as well as for treatment planning. With only a handful of reports on radiographic patterns of COVID-19 infection across the literature, we aim to describe the radiographic characteristics of COVID-19 pneumonia in Malaysia. Chest radiographs (CXR) of laboratory confirmed COVID-19 patients in Hospital Tawau, Sabah were retrieved and retrospectively analyzed by two radiologists. The radiographic patterns, distribution among subgroups, and evolution of the disease over time were determined. Criteria Findings Frequency (%) Baseline Chest Radiographs Normal 45 (54.9) Abnormal 37 (45.1) Lung Changes Ground glass opacities 29 (35.4) Consolidation 7 (8.5) Interstitial opacities 4 (4.9) Nodular opacities 1 (1.2) Distribution Peripheral 29 (35.4) Central 2 (2.4) Diffuse 5 (6.1) Lung Involvement Right lung 6 (7.3) Left lung 16 (19.5) Bilateral lungs 15 (18.3) Zonal Predominance Upper zone 4 (4.9) Middle zone 3 (3.7) Lower zone 24 (29.3) No zonal predominance 6 (7.3) Focality Focal 17 (20.7) Multifocal 20 (24.4) Other features Pleural effusion 3 (3.7) Pneumothorax 1 (1.2) Pulmonary nodules 1 (1.2) Lymphadenopathy 0 (0) Follow up Radiographs (n=38) Normal baseline CXRs becoming abnormal 0 (0) Resolution 6 (15.8) Improvement 9 (23.7) Progression 3 (7.9) Computed Tomography (n=5) Typical COVID-19 features 3 (60.0) 82 patients included MATERIALS AND METHODS RESULTS 65 (79.3%) 17 (20.7%) Mean age of 37 ± 15 years 25 8 18 16 1 5 9 24 40 9 16 33 6 2 4 45 M ale Female Symptomatic Asymptomatic Child ren Elde rly Comor bid No Comorb id DISTRIBUTION OF RADIOGRAPHS ACCORDING TO SUBGROUPS Normal CXR Abn ormal CXR with CO VID-1 9 pn eumon ia fe atu res CXR shows ground glass opacity at right lower zone. Coronal CT image shows ground glass opacity at right lower zone corresponds to the finding on radiograph. Asymptomatic COVID-19 patient with consolidation at the left upper zone (arrow) in the baseline radiograph with complete resolution of the opacities on day 5 of admission. REFERENCES C-07 NMRR NO:20-698-54570 CORONAVIRUS DISEASE -2019 (COVID-19): A RETROSPECTIVE REVIEW OF CHEST RADIOGRAPHS IN 82 PATIENTS. Mohana Letchumanan1, Adi Afiq Bin Md Anour1, Shubash Shander Ganapathy2, Syaman Harry1, Nik Shah Hizan Binti Nik Lah1, Norlimah Binti Arsad3, Nur Farhana Binti Ahmad Fisol4 1Department of Radiology, Tawau Hospital, 2Institute for Public Health, National Institutes of Health, 3Director of Tawau Hospital,4Clinical Research Center, Tawau Hospital 1. Choi H, Qi X, Yoon SH, Park SJ, Lee KH, Kim JY, et al. Extension of Coronavirus Disease 2019 (COVID-19) on Chest CT and Implications for Chest Radiograph Interpretation. Radiology: Cardiothoracic Imaging 2020; 2(2): e200107. 2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. 3. Lomoro P, Verde F, Zerboni F, Simonetti I, Borghi C, Fachinetti C, et al. COVID-19 pneumonia manifestations at the admission on chest ultrasound, radiographs, and CT: single-center study and comprehensive radiologic literature review. Eur J Radiol 2020; 7: 100231. CONCLUSION COVID-19 pneumonia presented with a specific radiographic pattern, comprising of ground glass opacities in peripheral and basilar distribution, affecting a single lung field. We observed these lung changes in both symptomatic and asymptomatic group of patients, and was more frequently manifested by patients with symptoms and comorbid, and those over 60 years of age. Chest radiograph is a useful adjunct screening tool, and in combination with clinical and epidemiological assessment may facilitate in early diagnosis of COVID-19 pneumonia. The authors would like to thank the Director General of Health, Malaysia, for the permission to present this poster