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Mapping COVID-19 functional sequelae: the perspective of nuclear medicine
Simone Cristina Soares Brandão1, Júlia de Oliveira Xavier Ramos2, Gustavo Freitas Alves de Arruda2
1Department of Internal Medicine, Divisions of Cardiology and Nuclear Imaging, Hospital das Clínicas, Federal University of Pernambuco (UFPE) Recife, PE, Brazil.
Abstract:
Severe acute respiratory syndrome coronavirus 2 infection is capable of affecting several organs. Direct viral toxicity, pro-inflammatory and pro-thrombotic induction, endothelial damage, immune imbalance, and dysregulation of the renin-angiotensin-aldosterone system are the mechanisms underlying the viral potential of multiple organ damage. The impairment of four organs stands out among severe patients: lung, heart, kidney, and endothelium. The nuclear medicine field holds accurate and safe exam techniques, such as positron emission tomography-computed tomography and scintigraphy, that allow the anatomophysiological study of the majority of human organ systems. By choosing the most appropriate method and radiopharmaceutical, analyzing the presence of inflammation, fibrosis, changes in perfusion, and function of desired organs is possible. Therefore, its use in the monitoring of patients with coronavirus disease 2019 becomes relevant, especially for monitoring sequelae. In this review, we discuss the use of Nuclear Medicine in the detection, monitoring, and therapeutic evaluation of pulmonary and extrapulmonary sequelae by coronavirus disease 2019.
Insights
Nuclear Medicine imaging can detect and monitor organ damage caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). These techniques are crucial for evaluating lung and non-lung sequelae after coronavirus disease 2019 (COVID-19).
Area of Science:
- Nuclear Medicine
- Infectious Diseases
- Cardiovascular Imaging
- Pulmonary Imaging
- Nephrology
- Vascular Biology
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to multi-organ damage through various mechanisms including direct viral toxicity, inflammation, and endothelial dysfunction.
- Lung, heart, kidney, and endothelium impairment are prominent in severe cases of coronavirus disease 2019 (COVID-19).
- Monitoring the long-term effects and sequelae of COVID-19 is essential for patient management.
Purpose of the Study:
- To review the application of Nuclear Medicine techniques in the detection and monitoring of organ damage following SARS-CoV-2 infection.
- To highlight the role of Nuclear Medicine in assessing pulmonary and extrapulmonary sequelae of COVID-19.
- To discuss the therapeutic evaluation of COVID-19 sequelae using advanced imaging modalities.
Main Methods:
- Utilizing accurate and safe Nuclear Medicine examinations such as Positron Emission Tomography-Computed Tomography (PET-CT) and scintigraphy.
- Employing appropriate radiopharmaceuticals to analyze organ-specific inflammation, fibrosis, perfusion, and function.
- Assessing the anatomophysiological status of multiple human organ systems.
Main Results:
- Nuclear Medicine imaging allows for detailed assessment of organ systems affected by SARS-CoV-2.
- These techniques can identify and quantify inflammation, fibrosis, and functional changes in organs like the lungs, heart, and kidneys.
- The study emphasizes the potential for Nuclear Medicine to track disease progression and treatment response in COVID-19 patients.
Conclusions:
- Nuclear Medicine offers valuable tools for the comprehensive evaluation of COVID-19 related organ damage and sequelae.
- Its application is critical for monitoring patients, especially those with persistent pulmonary and extrapulmonary manifestations.
- These imaging modalities support therapeutic decision-making and evaluation in the management of post-COVID-19 conditions.
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