tetano
Editor, Senior Moderator
Eur J Nucl Med Mol Imaging
. 2025 May 13.
doi: 10.1007/s00259-025-07297-w. Online ahead of print. Post-COVID-19 lung disease: utility of biochemical and imaging markers in uncovering residual lung inflammation and monitoring anti-inflammatory therapy, a prospective study
Yogita Khandelwal[SUP] 1 [/SUP], Manish Ora[SUP] 2 [/SUP], Bela Jain[SUP] 1 [/SUP], Manish Dixit[SUP] 2 [/SUP], Prakash Singh[SUP] 3 [/SUP], Ajmal Khan[SUP] 4 [/SUP], Alok Nath[SUP] 4 [/SUP], Vikas Agarwal[SUP] 5 [/SUP], Sanjay Gambhir[SUP] 6 [/SUP]
Affiliations
Purpose: Post-COVID-19 lung disease (PCLD) is a significant concern following the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. PCLD encompasses persistent debilitating respiratory symptoms and radiological changes beyond the acute disease phase. It highlights the ongoing search to identify and manage lingering diseases. This prospective study utilizes F18-Fludeoxyglucose (FDG) PET/CT to identify residual inflammatory lung lesions in PCLD. Treatment response was assessed after anti-inflammatory and antifibrotic therapies.
Materials and methods: Thirty patients post-severe COVID-19 pneumonia enrolled. They underwent baseline [SUP]18[/SUP]F-FDG PET/CT scans to unveil residual lung inflammation lesions on FDG and CT. They received antifibrotic (Pirfenidone) and anti-inflammatory (Methylprednisolone) drugs for 6-12 weeks. They were followed up for clinical, biochemical, and imaging treatment responses.
Results: Baseline [SUP]18[/SUP]F-FDG PET/CT revealed ongoing lung inflammation in all PCLD (mean SUV[SUB]max[/SUB]: 3.8 ± 2.3 and number of segments: 8±3 ). The mean CT severity score was 17.7 ± 3.4 with moderate (n = 16) or severe (n = 14) disease involvement. Mild, moderate, and severe [SUP]18[/SUP]F-FDG PET/CT categories were noted in the 8, 14, and 8 patients, respectively. Following treatment, a PET scan showed a significant decrease in disease extent (segments) and severity (FDG uptake) and an improvement in disease grading on imaging (97% of patients). In PET concordance, there was a significant clinical and radiological improvement with a fall in inflammatory markers (p < 0.005). Serum Ferritin and total leukocyte counts were significantly associated with PCLD severity on [SUP]18[/SUP]F-FDG PET/CT(p < 0.05).
Conclusion: This prospective study identifies and quantifies ongoing significant residual lung inflammation in PCLD on [SUP]18[/SUP]F-FDG PET/CT. Anti-inflammatory and antifibrotic drug therapy led to clinical and radiological improvement. [SUP]18[/SUP]F-FDG PET/CT as a non-invasive biomarker helped manage and follow up PCLD patients.
Clinical trial number: Not applicable.
Keywords: 18F-FDG PET/CT; Long-COVID; Lung infections; Post-COVID 19 lung disease.
. 2025 May 13.
doi: 10.1007/s00259-025-07297-w. Online ahead of print. Post-COVID-19 lung disease: utility of biochemical and imaging markers in uncovering residual lung inflammation and monitoring anti-inflammatory therapy, a prospective study
Yogita Khandelwal[SUP] 1 [/SUP], Manish Ora[SUP] 2 [/SUP], Bela Jain[SUP] 1 [/SUP], Manish Dixit[SUP] 2 [/SUP], Prakash Singh[SUP] 3 [/SUP], Ajmal Khan[SUP] 4 [/SUP], Alok Nath[SUP] 4 [/SUP], Vikas Agarwal[SUP] 5 [/SUP], Sanjay Gambhir[SUP] 6 [/SUP]
Affiliations
- PMID: 40355745
- DOI: 10.1007/s00259-025-07297-w
Purpose: Post-COVID-19 lung disease (PCLD) is a significant concern following the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. PCLD encompasses persistent debilitating respiratory symptoms and radiological changes beyond the acute disease phase. It highlights the ongoing search to identify and manage lingering diseases. This prospective study utilizes F18-Fludeoxyglucose (FDG) PET/CT to identify residual inflammatory lung lesions in PCLD. Treatment response was assessed after anti-inflammatory and antifibrotic therapies.
Materials and methods: Thirty patients post-severe COVID-19 pneumonia enrolled. They underwent baseline [SUP]18[/SUP]F-FDG PET/CT scans to unveil residual lung inflammation lesions on FDG and CT. They received antifibrotic (Pirfenidone) and anti-inflammatory (Methylprednisolone) drugs for 6-12 weeks. They were followed up for clinical, biochemical, and imaging treatment responses.
Results: Baseline [SUP]18[/SUP]F-FDG PET/CT revealed ongoing lung inflammation in all PCLD (mean SUV[SUB]max[/SUB]: 3.8 ± 2.3 and number of segments: 8±3 ). The mean CT severity score was 17.7 ± 3.4 with moderate (n = 16) or severe (n = 14) disease involvement. Mild, moderate, and severe [SUP]18[/SUP]F-FDG PET/CT categories were noted in the 8, 14, and 8 patients, respectively. Following treatment, a PET scan showed a significant decrease in disease extent (segments) and severity (FDG uptake) and an improvement in disease grading on imaging (97% of patients). In PET concordance, there was a significant clinical and radiological improvement with a fall in inflammatory markers (p < 0.005). Serum Ferritin and total leukocyte counts were significantly associated with PCLD severity on [SUP]18[/SUP]F-FDG PET/CT(p < 0.05).
Conclusion: This prospective study identifies and quantifies ongoing significant residual lung inflammation in PCLD on [SUP]18[/SUP]F-FDG PET/CT. Anti-inflammatory and antifibrotic drug therapy led to clinical and radiological improvement. [SUP]18[/SUP]F-FDG PET/CT as a non-invasive biomarker helped manage and follow up PCLD patients.
Clinical trial number: Not applicable.
Keywords: 18F-FDG PET/CT; Long-COVID; Lung infections; Post-COVID 19 lung disease.