Fluorodeoxyglucose Positron Emission Tomography Detects Persistent Arterial Inflammation After Symptomatic COVID-19 - 06/09/25

Doi : 10.1016/j.hlc.2025.03.005

Heidi Espedal, PhD ^a, Shipra Verma, MD ^b, Ambuj Roy, MD ^c, Nick S.R. Lan, MBBS, MClinRes, MSc ^d,^e,^f, Sheeraz Mohd, PhD ^d, Benjamin Bartlett, PhD ^d, Kamar Ali, MSc ^c, Natalie C. Ward, PhD ^g, Martin A. Ebert, PhD ^h,^i,^j,^k, Dick C. Chan, MD, PhD ^f, Gerald F. Watts, MD, PhD ^f,^l, Girish Dwivedi, MD, PhD ^d,^e,^f,^⁎ , Roslyn J. Francis, MD, PhD ^a,^f,^h,^m,^⁎
^a Western Australia National Imaging Facility, The University of Western Australia, Perth, WA, Australia
^b Department of Nuclear Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia
^c Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
^d Department of Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, Murdoch, WA, Australia
^e Department of Cardiology, South Metropolitan Health Service, Fiona Stanley Fremantle Hospitals Group, Murdoch, WA, Australia
^f Medical School, The University of Western Australia, Perth, WA, Australia
^g Dobney Hypertension Centre, Medical School, The University of Western Australia, Perth, WA, Australia
^h Australian Centre for Quantitative Imaging, Medical School, The University of Western Australia, Perth, WA, Australia
ⁱ School of Physics, Mathematics and Computing, The University of Western Australia, Perth, WA, Australia
^j Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia
^k School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
^l Cardiometabolic Clinic, Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia
^m Nuclear Medicine Department, Sir Charles Gairdner Hospital, Perth, WA, Australia

^∗Corresponding author at: Department of Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, 6 Verdun St, Nedlands, WA 6009, AustraliaDepartment of Advanced Clinical and Translational Cardiovascular ImagingHarry Perkins Institute of Medical Research6 Verdun StNedlandsWA6009Australia^∗∗Corresponding author at: Medical School, The University of Western Australia, 6 Verdun St, Nedlands, WA 6009, AustraliaMedical SchoolThe University of Western Australia6 Verdun StNedlandsWA6009Australia

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Abstract

Background

There is limited knowledge of persisting vascular and systemic inflammation in adults recovered from COVID-19. This study aimed to assess whether inflammation from symptomatic mild-to-moderate COVID-19 persists beyond the apparent clinical resolution of disease using fluorodeoxyglucose positron emission tomography (FDG-PET).

Method

This observational single-centre cohort study invited adults (aged >40 years) who had clinically recovered from mild-to-moderate COVID-19. Whole-body FDG-PET imaging and C-reactive protein test were performed on the same day after a minimum of 30 days after COVID-19 diagnosis. COVID-19–naive adults at high-risk for cardiovascular disease (CVD) were included for comparison (n=8); thoracic FDG-PET imaging was performed for these participants.

Results

FDG-PET imaging was performed after a median of 97 days (interquartile range [IQR] 75–113 days) after COVID-19 diagnosis. Participants who recovered from COVID-19 showed an increased arterial inflammation (median standard uptake value [SUV]_max 3.1; IQR 2.7–3.3) compared with the high-risk participants with CVD (median SUV_max 2.5; IQR 2.2–2.8; p<0.001). There was a moderate positive correlation between the total thoracic SUV_max and the bone marrow SUV_mean (Spearman r=0.58; p<0.001) and the spleen mean SUV_max (Spearman r=0.62, p<0.001) for participants who recovered from COVID-19.

Conclusions

Ongoing arterial inflammation is detected by FDG-PET imaging after mild-to-moderate COVID-19. Larger prospective studies are needed to assess the implications on CVD risk.

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Keywords : COVID-19, Vascular inflammation, FDG-PET, Infection

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Introduction

Methods

Study Design and Participants

¹⁸F-FDG-PET/CT Imaging

¹⁸F-FDG-PET Image Analyses

Statistical Analysis

Results

Participant Characteristics

¹⁸F-FDG Vascular Uptake Metrics and MDS

Discussion

Study Limitations

Conclusions

Esportazione

Vol 34 - N° 9

P. 969-976 - settembre 2025 Ritorno al numero

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Fluorodeoxyglucose Positron Emission Tomography Detects Persistent Arterial Inflammation After Symptomatic COVID-19 - 06/09/25

Abstract

Background

Method

Results

Conclusions

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