COvid iMaging With POSitron Emission Tomography

Not Applicable

• Conditions: Coronavirus Infection
• Interventions: Radiation: FDG-PET/CT

• Registration Number: NCT05009563
• Lead Sponsor: Semmelweis University Heart and Vascular Center

Brief Summary

We aim to study if metabolic intensity and extent according to pathologic pulmonary 18F-2-fluoro-2-deoxy-D-glucose (FDG)-uptake may correlate with the course of COVID-19 pneumonia and potentially yield prognostic value. Moreover, we aim to assess permanent changes after Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, such as pulmonary fibrosis and neuropsychiatric symptoms (anosmia, depression, fatigue) where evaluation with FDG-positron emission tomography (PET/CT) might have an impact on further patient care.

Detailed Description

Several case studies confirmed increased FDG-uptake on PET scans corresponding to typical pulmonary lesions on chest CT scans in patients with COVID-19 pneumonia. Furthermore, increased FDG-uptake most likely caused by inflammatory changes in SARS-CoV-2 infection were described in other organs, such as mediastinal lymph nodes, bone marrow, and the spleen. As COVID-19 frequently presents with anosmia and on rare occasions, symptoms of encephalitis, metabolic changes in the central nervous system (CNS) were also investigated by FDG-PET/CT, showing hypometabolism in the olfactory gyrus and the limbic system, while hypermetabolism was observed in the basal ganglia and the cerebellar vermis. Late changes in pulmonary CT-morphology, most commonly interstitial thickening and crazy paving are observed, suggesting permanent lung damage after SARS-CoV-2 infection in certain cases. Evaluation of metabolic activity of acute and late inflammatory changes could potentially provide clinical benefit as dedicated medication could be started to prevent further organ damage due to prolonged inflammation.

We aim to evaluate metabolic alterations in the lung parenchyma and potential extrapulmonary locations related to to COVID-19 with FDG-PET/CT.

Study Timeline

• Study Start: 2021-01-04
• Status Verified: 2021-08
• Study First Submitted: 2021-08-16
• Study First Submitted QC: 2021-08-16
• Last Update Submitted: 2021-08-16
• Study First Posted: 2021-08-17
• Last Update Posted: 2021-08-17
• Primary Completion: 2022-01-04
• Study Completion: 2022-01-04

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• Inpatients with RT-PCR proven SARS-CoV-2 infection of the Department of Pulmonology of Semmelweis University

Exclusion Criteria

• Age<40 years for men and <45 years for women
• Pregnancy
• Clinically unstable patients
• Patients in need of mechanical ventilation support
• Patients with known malignant disease

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Inpatients with RT-PCR proven SARS-CoV-2 infection	FDG-PET/CT	Inpatients with real-time reverse-transcriptase polymerase chain reaction (RT-PCR) proven SARS-CoV-2 infection of the Department of Pulmonology of Semmelweis University who will undergo whole-body FDG-PET/CT
patients undergoing FDG-PET/CT for oncological indication	FDG-PET/CT	Age- and gender-matched group of patients undergoing FDG-PET/CT for oncological indication in the same time period

Primary Outcome Measures

Name	Time	Method
extrapulmonary increased FDG-uptake	3 months	observation of sites with extrapulmonary hypermetabolic foci in possible conjunction with COVID-19 and brain metabolic changes, with follow-up scan

Secondary Outcome Measures

Name	Time	Method
total pulmonary metabolic inflammatory volume	3 months	measurement of metabolic activity of COVID-19 pneumonia and changes on follow-up scan

Trial Locations

Locations (1)

Semmelweis University Medical Imaging Centre; 🇭🇺 Budapest, Pest, Hungary