Functional Alterations Due to COVID-19 Lung Lesions-Lessons From a Multicenter V/Q Scan-Based Registry

Area of Science:

• Pulmonary imaging
• Nuclear medicine
• Radiology

Background:

• COVID-19 presents variable clinical and CT findings.
• Lung scintigraphy assesses regional ventilation and perfusion.
• V/Q SPECT/CT can evaluate ventilation-perfusion distribution.

Purpose of the Study:

• To describe ventilation and perfusion injury in COVID-19 patients.
• To correlate lung injury with specific chest CT lesion types.
• To utilize V/Q SPECT/CT for assessing COVID-19 lung disease.

Main Methods:

• A national registry of V/Q SPECT/CT scans during acute SARS-CoV-2 infection was analyzed.
• Chest CT findings were categorized into ground-glass opacities, crazy-paving, and consolidation.
• Ventilation and perfusion were semiquantitatively scored (0-4) for each lesion type.

Main Results:

• 145 patients with COVID-19 underwent V/Q SPECT/CT.
• Consolidation (61.4%) showed severe ventilation impairment (3.0 ± 0.9).
• Crazy-paving (29.7%) exhibited moderate-to-severe ventilation impairment (2.5 ± 1.1).
• Ground-glass opacities (22.8%) demonstrated moderate ventilation impairment (1.7 ± 1).
• All lesion types showed varying degrees of perfusion impairment.

Conclusions:

• A significant proportion of COVID-19 patients exhibit parenchymal lung lesions on CT.
• These lesions cause measurable ventilation and perfusion injury.
• Consolidation, crazy-paving, and ground-glass opacities are key lesions, ordered by frequency and functional impairment.
• V/Q SPECT/CT reveals characteristic ventilation-perfusion patterns in COVID-19 lung disease.