Journal Article

Vasculitis changes in COVID-19 survivors with persistent symptoms: an 18FFDG-PET/CT study

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

2021

Overview

PurposeSeveral patients experience unexplained persistent symptoms after SARS-CoV-2 recovering. We aimed at evaluating if 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) was able to demonstrate a persistent inflammatory process.MethodsRecovered adult COVID-19 patients, who complained unexplained persisting symptoms for more than 30 days during the follow-up visits, were invited to participate in the study. Patients fulfilling inclusion criteria were imaged by [18F]FDG positron emission tomography/computed tomography ([18F]FDG-PET/CT). Whole-body [18F]FDG-PET/CT, performed according to good clinical practice, was qualitatively (comparison with background/liver) and semi-quantitatively (target-to-blood pool ratio calculated as average SUVmax artery/average SUVmean inferior vena cava) analyzed. Negative follow-up [18F]FDG-PET/CT images of oncologic patients matched for age/sex served as controls. Mann-Whitney test was used to test differences between groups. SPSS version 26 was used for analyses.ResultsTen recovered SARS-CoV-2 patients (seven male and three females, median age 52 years, range 46–80) with persisting symptoms were enrolled in the study. Common findings at visual analysis were increased [18F]FDG uptake in bone marrow and blood vessels (8/10 and 6/10 cases, respectively). [18F]FDG uptake in bone marrow did not differ between cases and controls (p = 0.16). The total vascular score was similar in the two groups (p = 0.95). The target-to-blood pool ratio resulted higher in recovered SARS-CoV-2 patients than in controls.ConclusionAlthough the total vascular score was similar in the two groups, the target-to-blood pool ratio was significantly higher in three vascular regions (thoracic aorta, right iliac artery, and femoral arteries) in the recovered COVID-19 cohort than in controls, suggesting that SARS-CoV-2 induces vascular inflammation, which may be responsible for persisting symptoms.

• Publisher: Springer Nature B.V
• Subject: Aorta / Arteries / Blood vessels / Bone marrow / Computed tomography / Coronaviruses / COVID-19 / Femoral artery / Fluorine isotopes / Glucose / Inflammation / Long COVID / Positron emission / Positron emission tomography / Severe acute respiratory syndrome coronavirus 2 / Thorax / Tomography / Vasculitis / Veins & arteries