PET imaging reveals long-term heart and lung damage from COVID-19
New PET imaging data highlight the long-lasting impact of COVID-19, revealing changes to the heart and lungs that are not detectable by standard medical assessments.
The inflammatory alterations observed could indicate that individuals suffering from the long-term ramifications of COVID could be at increased risk of adverse cardiac and pulmonary conditions. Experts shared their findings recently in the Journal of Nuclear Medicine.
“Long COVID has emerged as a major public health challenge, and the long-term sequelae remain largely undefined,” corresponding author Maria G. Trivieri, MD, PhD, associate professor of medicine (cardiology), and diagnostic, molecular and interventional radiology at the Icahn School of Medicine, and colleagues noted. “This study brings us closer to understanding how SARS-CoV-2 affects the heart and lungs over time. We believe long COVID results in an inflammatory response that may predispose patients to premature coronary artery disease, pulmonary hypertension, and valvular damage such as stenosis or regurgitation.”
For their work, a team at Mount Sinai examined the cases of 100 patients who were treated for COVID at the institution between December 2020 and July 2021. Nearly one year after their initial infection, each patient was struggling with lingering cardiopulmonary symptoms, prompting 91 of them to undergo hybrid 18F-fluorodeoxyglucose PET/MRI to assess for both structural and metabolic abnormalities.
On imaging, more than half displayed inflammation of the heart muscle, pericardium, heart valves—especially the mitral valve—and aortic and pulmonary blood vessels. Scarring and thickening of the heart muscle were observed in 22 patients, while another 20 had fluid buildup and 28 displayed vascular inflammation of the aorta and pulmonary arteries.
Separate plasma protein analyses corroborated the team’s findings, revealing that many of the participants also had markers related to inflammation and immune signaling. What’s more, the patients who showed abnormalities on imaging and the plasma analysis all had persistent symptoms of long COVID, including chest pain, fatigue and shortness of breath.
Senior author Zahi Fayad, PhD, director of the Biomedical Engineering and Imaging Institute at the Icahn School of Medicine at Mount Sinai, believes their results should change how providers address long COVID symptoms.
“These findings should change how we approach care and surveillance—not only recognizing SARS-CoV-2 as a potential long-term cardiovascular risk factor, but also integrating molecular imaging into post-COVID evaluation protocols,” Fayad suggested. “We now have objective evidence that can guide earlier detection and potentially prevent future cardiopulmonary events.”
Learn more about the study’s findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.