Lung Abnormalities Detected with Hyperpolarized <sup>129</sup>Xe MRI                     in Patients with Long COVID

Grist, James T.; Collier, Guilhem J.; Walters, Huw; Kim, Minsuok; Chen, Mitchell; Eid, Gabriele Abu; Laws, Aviana; Matthews, Violet; Jacob, Kenneth; Cross, Susan; Eves, Alexandra; Durant, Marianne; McIntyre, A. S.; Thompson, A. A. Roger; Schulte, Rolf F.; Raman, Betty; Robbins, Peter A.; Wild, Jim M.; Fraser, Emily; Gleeson, Fergus

doi:10.1148/radiol.220069

Cited by 81 publications

(72 citation statements)

References 17 publications

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“…However, a few participants with normal CT yet had respiratory symptoms (15% [13/88]) and impaired DLCO (20% [15/76]). This finding corroborates publications which found that lung abnormalities post COVID-19 could be detected by other imaging methods when conventional CT was normal, such as air trapping by expiratory chest CT scans ( 21 , 22 ), and impairment in gas transfer by 129 Xe MRI ( 23 , 24 ).…”

Section: Discussionsupporting

confidence: 91%

Longitudinal Assessment of Chest CT Findings and Pulmonary Function after COVID-19 Infection

Han¹,

Chen²,

Fan³

et al. 2023

Radiology

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Background Information on pulmonary sequelae and pulmonary function at 2 years post recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are lacking. Purpose To longitudinally assess changes in chest CT abnormities and pulmonary function in patients after SARS-CoV-2 infection. Materials and Methods In this prospective study, patients discharged from the hospital after SARS-CoV-2 infection between January 15 and March 10, 2020 were considered for enrollment. Patients without chest CT scans on admission or with complete resolution of lung abnormities on discharge were excluded. Three serial chest CT scans and pulmonary function tests were obtained at 6 months (June 20–August 31, 2020), 12 months (December 20, 2020–February 3, 2021), and 2 years (November 16, 2021–January 10, 2022) after symptom onset. The term interstitial lung abnormalities (ILAs) and two subcategories, fibrotic ILAs and non-fibrotic ILAs, were used to describe the residual CT abnormalities on follow-up CT scans. Differences between groups were compared with χ², Fisher's exact test, or independent-samples t-test. Results Totally, 144 participants (median age, 60 [ranges 27-80] years; 79 men and 65 women) were included. On 2-year follow-up CT scans, 39% (56/144) of the subjects presented with ILAs, including 23% (33/144) wi fibrotic ILAs and 16% (23/144) with non-fibrotic ILAs. The remaining 88 cases (61%) showed complete radiological resolution. Over 2 years, the incidence of ILAs gradually decreased (54%, 42% and 39% at 6 months, 12 months and 2 years, respectively; P = .001). Respiratory symptoms (34% vs 15%, P =.007) and abnormal diffusing capacity of the lung for carbon monoxide (DLco,43% vs 20%, P = .004) more frequently occurred in participants with ILAs than those with complete radiological resolution. Conclusions More than one third of participants had persistent interstitial lung abnormalities at 2 years, which were associated with respiratory symptoms and decreased diffusion pulmonary function. See also the editorial by van Beek in this issue.

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Section: Discussionsupporting

confidence: 91%

Longitudinal Assessment of Chest CT Findings and Pulmonary Function after COVID-19 Infection

Han¹,

Chen²,

Fan³

et al. 2023

Radiology

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“…Although diagnostic tools exist for some components of long COVID (for example, tilt table tests for POTS 145 and MRI scans to detect cardiovascular impairment 68 ), diagnostic tools for long COVID are mostly in development, including imaging to detect microclots 63 , corneal microscopy to identify small fibre neuropathy 87 , new fragmentation of QRS complex on electrocardiograms as indicative of cardiac injury 146 and use of hyperpolarized MRI to detect pulmonary gas exchange abnormalities 147 . On the basis of the tests that are offered as standard care, the results for patients with long COVID are often normal; many providers are unaware of the symptom-specific testing and diagnostic recommendations from the ME/CFS community 148 .…”

Section: Diagnostic Tools and Treatmentsmentioning

confidence: 99%

Long COVID: major findings, mechanisms and recommendations

Davis¹,

McCorkell²,

et al. 2023

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Long COVID is an often debilitating illness that occurs in at least 10% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. More than 200 symptoms have been identified with impacts on multiple organ systems. At least 65 million individuals worldwide are estimated to have long COVID, with cases increasing daily. Biomedical research has made substantial progress in identifying various pathophysiological changes and risk factors and in characterizing the illness; further, similarities with other viral-onset illnesses such as myalgic encephalomyelitis/chronic fatigue syndrome and postural orthostatic tachycardia syndrome have laid the groundwork for research in the field. In this Review, we explore the current literature and highlight key findings, the overlap with other conditions, the variable onset of symptoms, long COVID in children and the impact of vaccinations. Although these key findings are critical to understanding long COVID, current diagnostic and treatment options are insufficient, and clinical trials must be prioritized that address leading hypotheses. Additionally, to strengthen long COVID research, future studies must account for biases and SARS-CoV-2 testing issues, build on viral-onset research, be inclusive of marginalized populations and meaningfully engage patients throughout the research process.

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“…Similar findings are described by the Israelian pediatric long COVID cohort study [ 13 ]. Additionally, other studies seem to point to possible lung abnormalities that cannot be detected by conventional imaging [ 49 , 50 ]. More studies related to this field are needed.…”

Section: Discussionmentioning

confidence: 99%

Social, Academic and Health Status Impact of Long COVID on Children and Young People: An Observational, Descriptive, and Longitudinal Cohort Study

et al. 2022

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There is a lack of evidence of the health impacts due to long COVID among children and young people (CYP). The objective of this study is to determine the main clinical characteristics of long COVID in CYP and to investigate the academic, social, and health status impacts of long COVID in this population. An observational, descriptive, and longitudinal study on CYP who presented COVID-19 symptoms for more than twelve weeks after SARS-CoV-2 infection was performed between December 2020 and May 2021. Fifty CYP were included, with a median age of 14.1 years, 33 (66%) were female, and 17 (34%) had a relative diagnosed with long COVID. Since the initial infection and up to the first visit, CYP had persisting symptoms for a median of 4.1 months, and for 18 (36%) CYP these symptoms persisted for more than 6 months. Fatigue (100%), neurocognitive disorders (74%), muscular weakness (74%), and headache (72%) were the most reported symptoms. A total of 9 (18%) CYP could not attend school, 17 (34%) had a reduced schedule, 33 (66%) showed a decreased school performance, and 68% had stopped extracurricular activities. This preliminary study shows the impact that long COVID has on the health, academic, and social life of CYP.

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Lung Abnormalities Detected with Hyperpolarized ¹²⁹Xe MRI in Patients with Long COVID

Cited by 81 publications

References 17 publications

Longitudinal Assessment of Chest CT Findings and Pulmonary Function after COVID-19 Infection

Longitudinal Assessment of Chest CT Findings and Pulmonary Function after COVID-19 Infection

Long COVID: major findings, mechanisms and recommendations

Social, Academic and Health Status Impact of Long COVID on Children and Young People: An Observational, Descriptive, and Longitudinal Cohort Study

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Lung Abnormalities Detected with Hyperpolarized 129Xe MRI in Patients with Long COVID

Cited by 81 publications

References 17 publications

Longitudinal Assessment of Chest CT Findings and Pulmonary Function after COVID-19 Infection

Longitudinal Assessment of Chest CT Findings and Pulmonary Function after COVID-19 Infection

Long COVID: major findings, mechanisms and recommendations

Social, Academic and Health Status Impact of Long COVID on Children and Young People: An Observational, Descriptive, and Longitudinal Cohort Study

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Lung Abnormalities Detected with Hyperpolarized ¹²⁹Xe MRI in Patients with Long COVID