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Persistent Xe MRI Pulmonary and CT Vascular Abnormalities in Symptomatic Individuals with Post-acute COVID-19 Syndrome. | LitMetric

Persistent Xe MRI Pulmonary and CT Vascular Abnormalities in Symptomatic Individuals with Post-acute COVID-19 Syndrome.

Radiology

From the Robarts Research Institute (A.M.M., M.J.M., H.K.K., V.D., G.P.), Department of Medical Biophysics (A.M.M., M.J.M., H.K.K., V.D., G.P.), Department of Physiology and Pharmacology (J.L., G.P.), Department of Physics and Astronomy (A.O.), Department of Medical Imaging (M.A., G.P.), and Division of Respirology, Department of Medicine (I.D., J.M.N., G.P.), Western University, 1151 Richmond St N, London, ON, Canada N6A 5B7; Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC (E.B., B.D.); Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada (S.S.); Translational Medicine Program, Hospital for Sick Children, Toronto, Canada (G.E.S.); Department of Medical Biophysics, University of Toronto, Toronto, Canada (G.E.S.); Department of Physics, Ryerson University, Toronto, Canada (M.K.); Chemistry Department, Lakehead University, Thunder Bay, Canada (M.S.A., Y.S., V.G.); Thunder Bay Regional Health Research Institute, Thunder Bay, Canada (M.S.A., Y.S., V.G.); and Northern Ontario School of Medicine, Thunder Bay, Canada (M.S.A.).

Published: November 2022

AI Article Synopsis

  • A study was conducted to explore the relationship between persistent symptoms and exercise limitations in patients with post-acute COVID-19 syndrome (PACS) using xenon 129 (Xe) MRI and CT pulmonary vascular measurements.
  • Participants included both hospitalized and never-hospitalized PACS patients, as well as healthy controls, to compare findings and assess lung function using various tests.
  • Results indicated notable differences in gas-transfer and vascular density between PACS patients and healthy controls, contributing to understanding the complexities of PACS and its effects on health and exercise capacity.

Article Abstract

Background: In patients with post-acute COVID-19 syndrome (PACS), abnormal gas-transfer and pulmonary vascular density have been reported, but such findings have not been related to each other or to symptoms and exercise limitation. The pathophysiologic drivers of PACS in patients previously infected with COVID-19 who were admitted to in-patient treatment in hospital (or ever-hospitalized patients) and never-hospitalized patients are not well understood.

Purpose: To determine the relationship of persistent symptoms and exercise limitation with xenon 129 (Xe) MRI and CT pulmonary vascular measurements in individuals with PACS.

Materials And Methods: In this prospective study, patients with PACS aged 18-80 years with a positive polymerase chain reaction COVID-19 test were recruited from a quaternary-care COVID-19 clinic between April and October 2021. Participants with PACS underwent spirometry, diffusing capacity of the lung for carbon monoxide (DLco), Xe MRI, and chest CT. Healthy controls had no prior history of COVID-19 and underwent spirometry, DLco, and Xe MRI. The Xe MRI red blood cell (RBC) to alveolar-barrier signal ratio, RBC area under the receiver operating characteristic curve (AUC), CT volume of pulmonary vessels with cross-sectional area 5 mm or smaller (BV5), and total blood volume were quantified. St George's Respiratory Questionnaire, International Physical Activity Questionnaire, and modified Borg Dyspnea Scale measured quality of life, exercise limitation, and dyspnea. Differences between groups were compared with use of Welch t-tests or Welch analysis of variance. Relationships were evaluated with use of Pearson () and Spearman (ρ) correlations.

Results: Forty participants were evaluated, including six controls (mean age ± SD, 35 years ± 15, three women) and 34 participants with PACS (mean age, 53 years ± 13, 18 women), of whom 22 were never hospitalized. The Xe MRI RBC:barrier ratio was lower in ever-hospitalized participants ( = .04) compared to controls. BV5 correlated with RBC AUC (ρ = .44, = .03). The Xe MRI RBC:barrier ratio was related to DLco ( = .57, = .002) and forced expiratory volume in 1 second (ρ = .35, = .03); RBC AUC was related to dyspnea (ρ = -.35, = .04) and International Physical Activity Questionnaire score (ρ = .45, = .02).

Conclusion: Xenon 129 (Xe) MRI measurements were lower in participants previously infected with COVID-19 who were admitted to in-patient treatment in hospital with post-acute COVID-19 syndrome, 34 weeks ± 25 after infection compared to controls. The Xe MRI measures were associated with CT pulmonary vascular density, diffusing capacity of the lung for carbon monoxide, exercise capacity, and dyspnea. Clinical trial registration no.: NCT04584671 © RSNA, 2022 See also the editorial by Wild and Collier in this issue.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272782PMC
http://dx.doi.org/10.1148/radiol.220492DOI Listing

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