COVID-19 Clinical Trial
Official title:
Assessment of Lung Inflammation With FDG PET/CT in COVID-19
The aim of the study was to assess the inflammatory status at the presumed peak of the inflammatory phase in non-critically ill patients requiring admission for COVID-19. Patients admitted with COVID-19 from March 27th to May 3rd, 2020 were prospectively enrolled. All patients had an initial chest CT-scan for diagnosis on admission and a second chest CT-scan for follow-up concomitant with a FDG PET/CT between day 6 and day 14 after the onset of symptoms.
[18F]-2-fluoro-2-deoxy-D-glucose PET/CT (FDG PET/CT) is a sensitive and quantitative technic
for detecting inflammatory process. Glucose uptake is correlated with increased anaerobic
glycolysis seen in activated inflammatory cells such as monocytes, lymphocytes and
granulocytes.
The aim of the study was to assess the inflammatory status at the presumed peak of the
inflammatory phase in non-critically ill patients requiring admission for COVID-19.
Patients were included if COVID-19 was confirmed according to the WHO guidance (11) by a
positive result of RT-PCR assay of nasal and pharyngeal swabs, if they were hospitalized
during the time period from day 6 to day 14 of the onset of symptoms, and if their initial
(on admission) chest CT-scan presented ground-glass opacities (GGO) or consolidation.
Group of 13 consecutive patients prospectively enrolled. All patients had an initial chest
CT-scan for diagnosis on admission and a second chest CT-scan for follow-up concomitant with
a FDG PET/CT between day 6 and day 14 after the onset of symptoms.
Based on the changes between the two chest CT, patients were classified as follows:
- CT worsening: increase of CT abnormalities extent > 20% or additional GGO or
consolidation. Conversion of GGO into consolidation was not considered as additional
finding.
- CT stability: changes of CT abnormalities extent ≤ 20% without additional GGO or
consolidation.
- CT improvement: decrease of CT abnormalities extent > 20% without additional GGO or
consolidation.
Based on FDG PET/CT imaging, patients' profiles were classified as follows:
- Inflammatory: lungs hypermetabolic volume ≥ 50 ml and / or SUVmax ≥ 7
- Low inflammatory: lungs hypermetabolic volume < 50 ml and / or SUVmax< 7 Patients'
short-term clinical outcome was classified as follows: worsening, stability,
improvement.
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