Long COVID hallmarks on [18F]FDG-PET/CT : a case-control study

© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..

PURPOSE: The present study hypothesised that whole-body [18F]FDG-PET/CT might provide insight into the pathophysiology of long COVID.

METHODS: We prospectively enrolled 13 adult long COVID patients who complained for at least one persistent symptom for >30 days after infection recovery. A group of 26 melanoma patients with negative PET/CT matched for sex/age was used as controls (2:1 control to case ratio). Qualitative and semi-quantitative analysis of whole-body images was performed. Fisher exact and Mann-Whitney tests were applied to test differences between the two groups. Voxel-based analysis was performed to compare brain metabolism in cases and controls. Cases were further grouped according to prevalent symptoms and analysed accordingly.

RESULTS: In 4/13 long COVID patients, CT images showed lung abnormalities presenting mild [18F]FDG uptake. Many healthy organs/parenchyma SUVs and SUV ratios significantly differed between the two groups (p ≤ 0.05). Long COVID patients exhibited brain hypometabolism in the right parahippocampal gyrus and thalamus (uncorrected p < 0.001 at voxel level). Specific area(s) of hypometabolism characterised patients with persistent anosmia/ageusia, fatigue, and vascular uptake (uncorrected p < 0.005 at voxel level).

CONCLUSION: [18F]FDG PET/CT acknowledged the multi-organ nature of long COVID, supporting the hypothesis of underlying systemic inflammation. Whole-body images showed increased [18F]FDG uptake in several "target" and "non-target" tissues. We found a typical pattern of brain hypometabolism associated with persistent complaints at the PET time, suggesting a different temporal sequence for brain and whole-body inflammatory changes. This evidence underlined the potential value of whole-body [18F]FDG PET in disclosing the pathophysiology of long COVID.

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

European journal of nuclear medicine and molecular imaging - Vol. 48, No. 10 (2021), p. 3187-3197

Language:

English

Contributors:

Sollini, Martina
Morbelli, Silvia
Ciccarelli, Michele
Cecconi, Maurizio
Aghemo, Alessio
Morelli, Paola
Chiola, Silvia
Gelardi, Fabrizia
Chiti, Arturo

Links:

Volltext

Keywords:

*COVID-19
*Fluorodeoxyglucose F18
[18F]FDG PET/CT
0Z5B2CJX4D
Adult
Brain hypometabolism
Case-Control Studies
Chronic COVID syndrome
Fluorodeoxyglucose F18
Humans
Infection
Inflammation
Journal Article
Long COVID
Positron Emission Tomography Computed Tomography
Radiopharmaceuticals
SARS-CoV-2

Notes:

Date Completed 13.09.2021

Date Revised 13.09.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1007/s00259-021-05294-3

PMID:

33677642

PPN (Catalogue-ID):

NLM323425488