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European Journal of Nuclear Medicine and Molecular Imaging

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02-11-2022 | Long-COVID Syndrome | Short Communication

Brain ¹⁸F-FDG PET imaging in outpatients with post-COVID-19 conditions: findings and associations with clinical characteristics

Authors: François Goehringer, Alexandra Bruyere, Matthieu Doyen, Sibylle Bevilacqua, Alexandre Charmillon, Sebastien Heyer, Antoine Verger

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2023

Abstract

Background

Brain ¹⁸F-FDG PET imaging has the potential to provide an objective assessment of brain involvement in post-COVID-19 conditions but previous studies of heterogeneous patient series yield inconsistent results. The current study aimed to investigate brain ¹⁸F-FDG PET findings in a homogeneous series of outpatients with post-COVID-19 conditions and to identify associations with clinical patient characteristics.

Methods

We retrospectively included 28 consecutive outpatients who presented with post-COVID-19 conditions between September 2020 and May 2022 and who satisfied the WHO definition, and had a brain ¹⁸F-FDG PET for suspected brain involvement but had not been hospitalized for COVID-19. A voxel-based group comparison with 28 age- and sex-matched healthy controls was performed (p-voxel at 0.005 uncorrected, p-cluster at 0.05 FWE corrected) and identified clusters were correlated with clinical characteristics.

Results

Outpatients with post-COVID-19 conditions exhibited diffuse hypometabolism predominantly involving right frontal and temporal lobes including the orbito-frontal cortex and internal temporal areas. Metabolism in these clusters was inversely correlated with the number of symptoms during the initial infection (r = − 0.44, p = 0.02) and with the duration of symptoms (r = − 0.39, p = 0.04). Asthenia and cardiovascular, digestive, and neurological disorders during the acute phase and asthenia and language disorders during the chronic phase (p ≤ 0.04) were associated with these hypometabolic clusters.

Conclusion

Outpatients with post-COVID-19 conditions exhibited extensive hypometabolic right fronto-temporal clusters. Patients with more numerous symptoms during the initial phase and with a longer duration of symptoms were at higher risk of persistent brain involvement.

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Verger A, Kas A, Dudouet P, Goehringer F, Salmon-Ceron D, Guedj E. Visual interpretation of brain hypometabolism related to neurological long COVID: a French multicentric experience. Eur J Nucl Med Mol Imaging. 2022;49:3197–202.CrossRefPubMedPubMedCentral

Verger A, Barthel H, Tolboom N, Fraioli F, Cecchin D, Albert NL, et al. 2-[18F]-FDG PET for imaging brain involvement in patients with long COVID: perspective of the EANM Neuroimaging Committee. Eur J Nucl Med Mol Imaging. 2022;s00259–022–05913–7.

A clinical case definition of post COVID-19 condition by a Delphi consensus. World Health Organisation website. [Internet]. 2021. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021. Accessed 26 Sept 2022.

Guedj E, Campion JY, Dudouet P, Kaphan E, Bregeon F, Tissot-Dupont H, et al. 18F-FDG brain PET hypometabolism in patients with long COVID. Eur J Nucl Med Mol Imaging. 2021;48:2823–33.CrossRefPubMedPubMedCentral

Sollini M, Morbelli S, Ciccarelli M, Cecconi M, Aghemo A, Morelli P, et al. Long COVID hallmarks on [18F]FDG-PET/CT: a case-control study. Eur J Nucl Med Mol Imaging. 2021;48:3187–97.CrossRefPubMedPubMedCentral

Dressing A, Bormann T, Blazhenets G, Schroeter N, Walter LI, Thurow J, et al. Neuropsychological profiles and cerebral glucose metabolism in neurocognitive Long COVID-syndrome. J Nucl Med. 2021;jnumed.121.262677.

Meyer PT, Hellwig S, Blazhenets G, Hosp JA. Molecular imaging findings on acute and long-term effects of COVID-19 on the brain: a systematic review. J Nucl Med. 2022;jnumed.121.263085.

Augustin M, Schommers P, Stecher M, Dewald F, Gieselmann L, Gruell H, et al. Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study. The Lancet Regional Health - Europe. 2021;6: 100122.CrossRefPubMedPubMedCentral

Guedj E, Varrone A, Boellaard R, Albert NL, Barthel H, van Berckel B, et al. EANM procedure guidelines for brain PET imaging using [18F]FDG, version 3. Eur J Nucl Med Mol Imaging. 2022;49:632–51. Accessed 26 Sept 2022.

10.

WHO COVID-19: case definitions. World Health Organisation website. [Internet]. 2020. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-Surveillance_Case_Definition-2020.2. Accessed 26 Sept 2022.

11.

Michelen M, Manoharan L, Elkheir N, Cheng V, Dagens A, Hastie C, et al. Characterising long COVID: a living systematic review. BMJ Glob Health. 2021;6: e005427.CrossRefPubMed

12.

Heiss W-D. PET in coma and in vegetative state: PET in coma and in vegetative state. Eur J Neurol. 2012;19:207–11.CrossRefPubMed

13.

Carota A, Bogousslavsky J. Minor hemisphere major syndromes. In: Bogousslavsky J, editor. Frontiers of Neurology and Neuroscience [Internet]. S. Karger AG; 2018 [cited 2022 Sep 26]. p. 1–13. Available from: https://www.karger.com/Article/FullText/475690

14.

Fond G, Masson M, Lançon C, Richieri R, Guedj E. The neuroinflammatory pathways of post-SARS-CoV-2 psychiatric disorders. L’Encéphale. 2021;47:399–400.CrossRefPubMedPubMedCentral

15.

Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, et al. Attributes and predictors of long COVID. Nat Med. 2021;27:626–31.CrossRefPubMedPubMedCentral

16.

Guedj E, Morbelli S, Kaphan E, Campion J-Y, Dudouet P, Ceccaldi M, et al. From early limbic inflammation to long COVID sequelae. Brain. 2021;144:e65–e65.CrossRefPubMed

Title: Brain 18F-FDG PET imaging in outpatients with post-COVID-19 conditions: findings and associations with clinical characteristics
Authors: François Goehringer
Alexandra Bruyere
Matthieu Doyen
Sibylle Bevilacqua
Alexandre Charmillon
Sebastien Heyer
Antoine Verger
Publication date: 02-11-2022
Publisher: Springer Berlin Heidelberg
Keywords: Long-COVID Syndrome
COVID-19
Post-COVID Syndrome
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2023
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-022-06013-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Brain ¹⁸F-FDG PET imaging in outpatients with post-COVID-19 conditions: findings and associations with clinical characteristics

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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