Coronavirus Infection
Conditions
Keywords
COVID19, PET-CT, brain, lung
Brief summary
We aim to study if metabolic intensity and extent according to pathologic pulmonary 18F-2-fluoro-2-deoxy-D-glucose (FDG)-uptake may correlate with the course of COVID-19 pneumonia and potentially yield prognostic value. Moreover, we aim to assess permanent changes after Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, such as pulmonary fibrosis and neuropsychiatric symptoms (anosmia, depression, fatigue) where evaluation with FDG-positron emission tomography (PET/CT) might have an impact on further patient care.
Detailed description
Several case studies confirmed increased FDG-uptake on PET scans corresponding to typical pulmonary lesions on chest CT scans in patients with COVID-19 pneumonia. Furthermore, increased FDG-uptake most likely caused by inflammatory changes in SARS-CoV-2 infection were described in other organs, such as mediastinal lymph nodes, bone marrow, and the spleen. As COVID-19 frequently presents with anosmia and on rare occasions, symptoms of encephalitis, metabolic changes in the central nervous system (CNS) were also investigated by FDG-PET/CT, showing hypometabolism in the olfactory gyrus and the limbic system, while hypermetabolism was observed in the basal ganglia and the cerebellar vermis. Late changes in pulmonary CT-morphology, most commonly interstitial thickening and crazy paving are observed, suggesting permanent lung damage after SARS-CoV-2 infection in certain cases. Evaluation of metabolic activity of acute and late inflammatory changes could potentially provide clinical benefit as dedicated medication could be started to prevent further organ damage due to prolonged inflammation. We aim to evaluate metabolic alterations in the lung parenchyma and potential extrapulmonary locations related to to COVID-19 with FDG-PET/CT.
Interventions
RADIATIONFDG-PET/CT
whole-body F-18-fluoro-deoxy-glucose positron emission tomography/computed tomography
Sponsors
Semmelweis University Department of Pulmonology
Semmelweis University Medical Imaging Centre
Semmelweis University Heart and Vascular Center
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Inpatients with RT-PCR proven SARS-CoV-2 infection of the Department of Pulmonology of Semmelweis University
Exclusion criteria
* Age\<40 years for men and \<45 years for women * Pregnancy * Clinically unstable patients * Patients in need of mechanical ventilation support * Patients with known malignant disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| extrapulmonary increased FDG-uptake | 3 months | observation of sites with extrapulmonary hypermetabolic foci in possible conjunction with COVID-19 and brain metabolic changes, with follow-up scan |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| total pulmonary metabolic inflammatory volume | 3 months | measurement of metabolic activity of COVID-19 pneumonia and changes on follow-up scan |
Other
| Measure | Time frame | Description |
|---|---|---|
| cognitive status and quality of life | 3 months | investigation of possible COVID-19-related cognitive changes and impact on quality of life, with follow-up |
Countries
Hungary
Contacts
Primary ContactPál Maurovich Horvat, MD PhD MPH
Outcome results
None listed