The added value of lung perfusion scintigraphy semiquantitative measures in post-COVID patients with persistent dyspnea without pulmonary embolism

ABSTRACT

Background

Persistent dyspnea is frequent in post-COVID patients, even in the absence of pulmonary embolism (PE). In this scenario, the role of lung perfusion scintigraphy is unclear. The present study correlated scintigraphy-based semiquantitative perfusion parameters with chest high-resolution computed tomography (hrCT) volumetric indexes and clinical data in post-COVID patients with persistent dyspnea.

Research design and methods

Sixty patients (30 post-COVID and 30 not previously affected by COVID-19) with persistent dyspnea submitted to lung perfusion scintigraphy and hrCT were retrospectively recruited. Perfusion rates of the pulmonary fields and hrCT-based normalized inflated, emphysematous, infiltrated, collapsed, and vascular lung volumes were calculated. Inflammatory and coagulation biomarkers were collected. PE at imaging was an exclusion criterion.

Results

Compared to controls, reduced perfusion rates of the lower pulmonary fields and higher perfusion rates of the middle ones were observed in post-COVID patients, while hrCT findings were superimposable between the two groups. Perfusion rates of lower pulmonary fields were significantly associated only with abnormal lung volumes at hrCT.

Conclusions

In post-COVID dyspnea without PE, lung perfusion scintigraphy may reveal a pulmonary involvement not detectable by hrCT. Post-COVID patients may show decreased perfusion rates of lower pulmonary fields in the presence of normal vascular density and markers of inflammation/coagulation.

KEYWORDS:

• Chest computed tomography
• COVID-19
• lung perfusion scintigraphy
• post-COVID syndrome
• pulmonary embolism
• semiquantitative analysis

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conceptualization, F Lanfranchi and M Bauckneht; data collection: F Lanfranchi, S Maggio, C Delucchi and F Bertoldi; data analysis: F Lanfranchi and M Bauckneht; original draft preparation, F Lanfranchi and M Bauckneht, review and editing: all authors. All authors have read and agreed to the published version of the manuscript.

Availability of data and material

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ethical approval

The study was approved by the regional ethical committee (CER Liguria code 671/2021); all procedures and informed consent collection were in accordance with the ethical standards of the 1964 Helsinki Declaration and all subsequent revisions.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

All subjects gave their informed consent to publish their anonymized data.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17434440.2023.2277236

Additional information

Funding

This paper was not funded.