Longitudinal follow-up of postacute COVID-19 syndrome: DL_CO, quality-of-life and MRI pulmonary gas-exchange abnormalities

Abstract

129Xe MRI red blood cell to alveolar tissue plasma ratio (RBC:TP) abnormalities have been observed in ever-hospitalised and never-hospitalised people with postacute COVID-19 syndrome (PACS). But, it is not known if such abnormalities resolve when symptoms and quality-of-life scores improve. We evaluated 21 participants with PACS, 7±4 months (baseline) and 14±4 months (follow-up) postinfection. Significantly improved diffusing capacity of the lung for carbon monoxide (DLCO, Δ=14%pred;95%CI 7 to 21, p<0.001), postexertional dyspnoea (Δ=−0.7; 95%CI=−0.2 to –1.2, p=0.019), St George’s Respiratory Questionnaire-score (SGRQ Δ=−6; 95% CI=−1 to –11, p=0.044) but not RBC:TP (Δ=0.03; 95% CI=0.01 to 0.05, p=0.051) were observed at 14 months. DLCOcorrelated with RBC:TP (r=0.60, 95% CI=0.22 to 0.82, p=0.004) at 7 months. While DLCOand SGRQ measurements improved, these values did not normalise 14 months post-infection. ClinicalTrials.govNCT04584671.

Impaired function in the lung periphery following COVID‐19 is associated with lingering breathing difficulties

“…It is reasonable to assume that SARS-CoV-2 induced destruction of alveolar cells and remodeling in extracellular matrix (Guizani et al, 2021) will result in structural acinar asymmetries, reflected by S acin . This alveolar epithelium injury is further supported by findings of reduced gas transfer ability in 129 Xe MRI studies in this patient group (Grist et al, 2022;Matheson et al, 2022Matheson et al, , 2023.…”

Ventilation Defects at 129Xe MRI in Postacute COVID-19 Syndrome: Back to Normal after 1 Year?

“…Recently, the investigators reported on a small single-center group of 21 participants (seven female; mean age, 56 years) with PACS and persistently abnormal 129 Xe MRI red blood cell–to-tissue plasma ratio values 14 months after infection compared to baseline (7 months after COVID-19 infection). However, the participants also showed significantly normalized levels of percent predicted DL CO in the same observation period ( 8 ). In addition, Grist et al reported in a prospective study of 11 participants significant differences in mean red blood cell–to-tissue plasma ratio values between healthy volunteers and posthospitalized participants with post-COVID-19 condition and nonhospitalized participants with post-COVID-19 condition 5-9 months after COVID-19 infection, despite the presence of normal CT findings ( 9 ).…”

Neurologische Langzeitfolgen von COVID-19

“…So existiert zum einen eine umfangreiche Evidenz zu postinfektiösen Endorganschäden. Dabei konnten neben kardiopulmonalen Schädigungen [21,22,23,24] auch Beeinträchtigungen des zentralen Nervensystems festgestellt werden [25]. Bildgebende Studien wiesen strukturelle Schäden im olfaktorischen System nach einer überstandenen COVID-19-Erkrankung nach [26,27].…”