Inflammatory response in lungs and extrapulmonary sites detected by [18F] fluorodeoxyglucose PET/CT in convalescing COVID-19 patients tested negative for coronavirus

Xu, Jibin; Chen, Lijuan; Fu, Caixia; Yi, Kang; Zhang, Weifeng; Fakhri, Georges Ei; Gu, Jianqin; Shao, Fengmin; Wang, Meiyun

doi:10.1007/s00259-020-05083-4

Cited by 33 publications

(36 citation statements)

References 39 publications

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“…This observation is in agreement with the results reported by Bai et al. [ 23 ] who described persistent lung 2-[ 18 F]FDG PET/CT abnormalities in seven convalescing patients after severe COVID-19 infection and two consecutive negative molecular oro/nasopharyngeal swabs. A similar 2-[ 18 F]FDG PET/CT finding was also described by Fu et al.…”

Section: Discussionsupporting

confidence: 93%

Impact of COVID-19 pandemic on 2-[18F]FDG PET/CT imaging work-flow in a single medical institution: comparison among the three Italian waves

Maurea

Bombace

Mainolfi

et al. 2022

Heliyon

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Section: Discussionsupporting

confidence: 93%

Impact of COVID-19 pandemic on 2-[18F]FDG PET/CT imaging work-flow in a single medical institution: comparison among the three Italian waves

Maurea

Bombace

Mainolfi

et al. 2022

Heliyon

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“…Residual inflammation has been documented by ( 18 F) fluorodeoxyglucose positron emission tomography/CT in patients convalescing post-severe COVID, in organs such as the lungs, mediastinal lymph nodes, liver and spleen, immediately after RT-PCR negative conversion[ 7 ]. This residual inflammation could theoretically explain to some extent the pattern of hepatocytolysis seen in our patient, however, our case was a mild form of disease, not severe, and displayed a much higher ALT increase, while in the cited study most patients (6/7) had normal ALT levels at the time when positron emission tomography/computed tomography detected liver inflammation, and only one of the patients had low-grade cytolysis (ALT 1.5 times the upper normal limit)[ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Transient immune hepatitis as post-coronavirus disease complication: A case report

Drăgănescu¹,

Săndulescu²,

Bilaşco³

et al. 2021

WJCC

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BACKGROUND We report a case of post-coronavirus disease (COVID) immune hepatitis occurring in a young male with no pre-existing comorbidities. CASE SUMMARY A previously healthy 21-year-old male patient was admitted to our hospital with mild COVID-19. During the course of in-hospital isolation and monitoring, he developed an alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increase, with the enzymes peaking at day 24 (ALT 15 times the upper normal limit), with preserved liver function. The liver enzyme increase occurred 20 d after the complete clinical remission of COVID-19, and ALT dynamics paralleled the increase in total antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The case was interpreted as post-COVID immune hepatitis, with extensive laboratory investigations excluding other potential causes. The hepatocytolysis remitted 20 d after the peak ALT, without further intervention, with complete recovery, but the total anti-SARS-CoV-2 antibodies continued to increase the next 5 mo following the acute infection. CONCLUSION Close attention should also be paid to young patients with mild forms of disease, and a high index of suspicion should be maintained for post-COVID complications.

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“… 42,43 FDG avid intrathoracic and supraclavicular nodes with COVID-19 infection have been reported in several studies with varied frequency, with or without CT enlargement, 20,22–25 whilst only one study has reported increased splenic uptake (5/13 patients) and increased bone marrow uptake 25 ; extrapulmonary abnormalities involving the salivary glands 19 and gastro-intestinal tract 18 were not routinely assessed for during our study. The presence of generalised systemic inflammation has been confirmed in small cohorts of patients recovering from COVID-19 infection (lungs, mediastinal nodes, spleen, liver, large vessels), 44,45 as well as in patients with post-COVID syndrome 46 in conjunction with findings of brain hypometabolism. 47,48 …”

Section: Discussionmentioning

confidence: 91%

A case–control evaluation of pulmonary and extrapulmonary findings of incidental asymptomatic COVID-19 infection on FDG PET-CT

Subesinghe

Bhuva

Dunn

et al. 2021

The British Journal of Radiology

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Objectives: To describe the findings of incidental asymptomatic COVID-19 infection on FDG PET-CT using a case-control design. Methods: Incidental pulmonary findings suspicious of asymptomatic COVID-19 infection on FDG PET-CT were classified as a confirmed (positive RT-PCR test) or suspected case (no/negative RT-PCR test). Control cases were identified using a 4:1 control:case ratio. Pulmonary findings were re-categorised by two reporters using the BSTI classification. SUV metrics in ground glass opacification (GGO)/consolidation (where present), background lung, intrathoracic nodes, liver, spleen, and bone marrow were measured. Results: 7/9 confirmed and 11/15 suspected cases (COVID-19 group) were re-categorised as BSTI 1 (classic/probable COVID-19) or BSTI 2 (indeterminate COVID-19); 0/96 control cases were categorised as BSTI 1. Agreement between two reporters using the BSTI classification was almost perfect (weighted κ = 0.94). SUVmax GGO/consolidation (5.1 vs 2.2; p < 0.0001) and target-to-background ratio, normalised to liver SUVmean(2.4 vs 1.0; p < 0.0001) were higher in the BSTI 1 & two group vs BSTI 3 (non-COVID-19) cases. SUVmax GGO/consolidation discriminated between the BSTI 1 & two group and BSTI 3 (non-COVID-19) cases with high accuracy (AUC = 0.93). SUV metrics were higher (p < 0.05) in the COVID-19 group vs control cases in the lungs, intrathoracic nodes, and spleen. Conclusion: Asymptomatic COVID-19 infection on FDG PET-CT is characterised by bilateral areas of FDG avid (intensity > x2 liver SUVmean) GGO/consolidation and can be identified with high interobserver agreement using the BSTI classification. There is generalised background inflammation within the lungs, intrathoracic nodes, and spleen. Advances in knowledge: Incidental asymptomatic COVID-19 infection on FDG PET-CT, characterised by bilateral areas of ground glass opacification and consolidation, can be identified with high reproducibility using the BSTI classification. The intensity of associated FDG uptake (>x2 liver SUVmean) provides high discriminative ability in differentiating such cases from pulmonary findings in a non-COVID-19 pattern. Asymptomatic COVID-19 infection causes a generalised background inflammation within the mid-lower zones of the lungs, hilar and central mediastinal nodal stations, and spleen on FDG PET-CT. A case-control evaluation of pulmonary and extrapulmonary findings of incidental asymptomatic COVID-19 infection on FDG PET-CT.

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Inflammatory response in lungs and extrapulmonary sites detected by [18F] fluorodeoxyglucose PET/CT in convalescing COVID-19 patients tested negative for coronavirus

Cited by 33 publications

References 39 publications

Impact of COVID-19 pandemic on 2-[18F]FDG PET/CT imaging work-flow in a single medical institution: comparison among the three Italian waves

Impact of COVID-19 pandemic on 2-[18F]FDG PET/CT imaging work-flow in a single medical institution: comparison among the three Italian waves

Transient immune hepatitis as post-coronavirus disease complication: A case report

A case–control evaluation of pulmonary and extrapulmonary findings of incidental asymptomatic COVID-19 infection on FDG PET-CT

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