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Eur J Nucl Med Mol Imaging . Relation of pulmonary diffusing capacity changes to HRCT chest and V/Q SPECT findings at short-term and intermediate fo

tetano

Editor, Senior Moderator
Eur J Nucl Med Mol Imaging


. 2025 Oct 30.
doi: 10.1007/s00259-025-07598-0. Online ahead of print. Relation of pulmonary diffusing capacity changes to HRCT chest and V/Q SPECT findings at short-term and intermediate follow-up after COVID-19: a prospective cohort study (The secure study)

Thora Wesenberg Helt[SUP] 1 [/SUP], Rie Skovly Thomsen[SUP] 2 [/SUP], Jan Christensen[SUP] 3 [/SUP], Thomas Kromann Lund[SUP] 4 [/SUP], Anna Kalhauge[SUP] 5 [/SUP], Frederikke Rönsholt[SUP] 4 [/SUP], Daria Podlekavera[SUP] 6 [/SUP], Elisabeth Arndal[SUP] 7 [/SUP], Anne-Mette Lebech[SUP] 6 8 [/SUP], Ronan M G Berg[SUP] 9 10 11 12 [/SUP], Terese L Katzenstein[SUP] 6 [/SUP], Jann Mortensen[SUP] 1 8 13 [/SUP]



Affiliations
Abstract

Background: Several patients exhibit a severity-dependent reduced pulmonary diffusing capacity (D[SUB]LCOc[/SUB]) following coronavirus disease 2019 (COVID-19) infection. This has been attributed to fibrosis-like restrictive lung disease, as shown by chest high-resolution computed tomography (HRCT), and concurrent ventilatory disturbances observed by ventilation-perfusion single-photon emission computed tomography (V/Q SPECT) imaging. The aim of this study was to investigate whether reductions in D[SUB]L,COc[/SUB] at short- and intermediate-term follow-up were associated with initial severity of COVID-19, and to which extend this was linked to the presence of fibrosis-like abnormalities on HRCT and ventilatory disturbances on V/Q SPECT.
Methods: A total of 153 patients diagnosed with COVID-19 between March 2020 and March 2021 were included in the study. The patients underwent lung function testing, chest HRCT, and V/Q SPECT at short-term (5.6 months) follow-up. Individuals exhibiting any evidence of post-COVID-19 sequelae (n = 121) were also referred to intermediate follow-up (12.5 months).
Results: At short-term follow-up, a severity dependent reduction in D[SUB]L,COc[/SUB] was observed, which was not evident at intermediate follow-up. At both short-term and intermediate follow-up, HRCT showed ground-glass opacity (GGO) and fibrosis-like abnormalities related to disease severity. Most patients had V/Q defects mainly with ventilatory abnormalities, including both matched and inversely matched defects at both follow-up times.
Conclusion: The severity-dependent reduction in D[SUB]L,COc[/SUB] at short-term follow-up, associated with restrictive lung function pattern, GGO and fibrosis on HRCT, and ventilatory disturbances on V/Q SPECT, showed spontaneous recovery by intermediate follow-up. However, the restrictive ventilatory disturbances and associated morphological changes persisted.

Keywords: COVID-19; Long COVID; Pulmonary diffusing capacity; SARS-CoV-2.

 
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