Trivieri Maria Giovanna, Devesa Ana, Robson Philip M, Bose Sonali, Cangut Busra, Liao Steve, Kaufman Audrey, Pyzik Renata, Fauveau Valentin, Wood Jamie, Shpiner Aaron, Yoo Edwin, Huang Sarayu, Calcagno Claudia, Mani Venkatesh, Thapi Sahityasri, Contreras Johanna, Nie Kai, Kim-Schulze Seunghee, Gnjatic Sacha, Merad Miriam, Ghesani Munir, Putrino David, Jacobi Adam, Mancini Donna, Powell Charles, Fayad Zahi A
Icahn School of Medicine at Mount Sinai, Mount Sinai Fuster Heart Hospital, New York, New York;
BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
J Nucl Med. 2025 Jul 1;66(7):1126-1134. doi: 10.2967/jnumed.124.268980.
The objective of this study is to describe the prevalence of inflammatory cardiopulmonary findings in a prospective cohort of long coronavirus disease (LC) patients. Subjects with a history of coronavirus disease 2019 infection, persistent cardiopulmonary symptoms 9-12 mo after initial infection, and a clinical assessment compatible with LC underwent cardiopulmonary F-FDG PET/MRI, dual-energy CT (DECT) of the lungs, and plasma protein analysis (subgroup). A control group that included subjects with a history of acute severe acute respiratory syndrome coronavirus 2 infection but without cardiopulmonary symptoms at recruitment was also characterized. Ninety-eight patients (median age, 48.5 y; 47% men) were enrolled. The most common LC symptom was shortness of breath (80%), and 27% of participants were hospitalized. Of the subjects, 90% presented abnormalities in DECT, with 67% and 59% of participants demonstrating pulmonary infiltrates and abnormal perfusion, respectively. PET/MRI was abnormal for 57% of subjects: 24% showed cardiac involvement suggestive of myocarditis, 22% presented uptake reminiscent of pericarditis, 11% showed periannular uptake, and 30% showed vascular uptake (aortic or pulmonary). There was no myocardial, pericardial, periannular, or pulmonary uptake on the PET/MRI scans of the control group ( = 9). Analysis of plasma protein concentrations showed significant differences between the LC and the control groups. Lastly, the plasma protein profile was significantly different among LC patients with abnormal and normal PET/MRI. In LC subjects evaluated up to a year after coronavirus disease 2019 infection, our results indicate a high prevalence of abnormalities on PET/MRI and DECT, as well as significant differences in the peripheral biomarker profile, which might warrant further monitoring to exclude the development of complications such as pulmonary hypertension and valvular disease.
本研究的目的是描述在一组前瞻性的长新冠患者队列中炎症性心肺表现的患病率。有2019冠状病毒病感染史、初次感染后9至12个月持续存在心肺症状且临床评估符合长新冠的受试者接受了心肺F-FDG PET/MRI、肺部双能CT（DECT）和血浆蛋白分析（亚组）。还对一个对照组进行了特征描述，该对照组包括有急性重症严重急性呼吸综合征冠状病毒2感染史但在招募时无心肺症状的受试者。共纳入98例患者（中位年龄48.5岁；47%为男性）。最常见的长新冠症状是气短（80%），27%的参与者曾住院治疗。在这些受试者中，90%在DECT上表现异常，分别有67%和59%的参与者显示有肺部浸润和灌注异常。57%的受试者PET/MRI异常：24%显示有提示心肌炎的心脏受累情况，22%表现出类似心包炎的摄取，11%显示瓣环周围摄取，30%显示血管摄取（主动脉或肺动脉）。对照组（n = 9）的PET/MRI扫描未发现心肌、心包、瓣环周围或肺部摄取。血浆蛋白浓度分析显示长新冠组与对照组之间存在显著差异。最后，PET/MRI异常和正常的长新冠患者之间血浆蛋白谱存在显著差异。在2019冠状病毒病感染后长达一年的长新冠受试者中，我们的结果表明PET/MRI和DECT上异常的患病率很高，以及外周生物标志物谱存在显著差异，这可能需要进一步监测以排除诸如肺动脉高压和瓣膜病等并发症的发生。
