PT  - JOURNAL ARTICLE
AU  - Debs, P.
AU  - Khalili, N.
AU  - Solnes, L.
AU  - Al-Zaghal, A.
AU  - Sair, H.I.
AU  - Yedavalli, V.
AU  - Luna, L.P.
TI  - Post-COVID-19 Brain [<sup>18</sup>F] FDG-PET Findings: A Retrospective Single-Center Study in the United States
AID  - 10.3174/ajnr.A7863
DP  - 2023 Apr 27
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2023/04/27/ajnr.A7863.short
4100  - http://www.ajnr.org/content/early/2023/04/27/ajnr.A7863.full
AB  - BACKGROUND AND PURPOSE: The pathophysiology of neurologic manifestations of postacute sequelae of Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is not clearly understood. Our aim was to investigate brain metabolic activity on [18F] FDG-PET/CT scans in patients with a history of coronavirus disease 2019 (COVID-19) infection before imaging.MATERIALS AND METHODS: This retrospective study included 45 patients who underwent [18F] FDG-PET/CT imaging for any reason and had, at least once, tested positive for COVID-19 at any time before imaging. Fifteen patients had available [18F] FDG-PET scans obtained under identical conditions before the infection. A group of 52 patients with melanoma or multiple myeloma who underwent [18F] FDG-PET/CT were used as controls. Whole-brain 2-sample t test analysis was performed using SPM software to identify clusters of hypo- and hypermetabolism and compare brain metabolic activity between patients with COVID-19 and controls. Paired sample t test comparison was also performed for 15 patients, and correlations between metabolic values of clusters and clinical data were measured.RESULTS: Compared with the control group, patients with a history of COVID-19 infection exhibited focal areas of hypometabolism in the bilateral frontal, parietal, occipital, and posterior temporal lobes and cerebellum (P = .05 uncorrected at the voxel level, family-wise error–corrected at the cluster level) that peaked during the first 2 months, improved to near-complete recovery around 6 months, and disappeared at 12 months. Hypermetabolism involving the brainstem, cerebellum, limbic structures, frontal cortex, and periventricular white matter was observed only at 2-6 months after infection. Older age, neurologic symptoms, and worse disease severity scores positively correlated with the metabolic changes.CONCLUSIONS: This study demonstrates a profile of time-dependent brain PET hypo- and hypermetabolism in patients with confirmed SARS-CoV-2 infection.BMIbody mass indexCOVID-19coronavirus disease 2019FWEfamily-wise errorGLMgeneral linear modelneuro-PASCneurologic manifestations of postacute sequelae of SARS-CoV-2 infectionPASCpostacute sequelae of SARS-CoV-2PCRpolymerase chain reactionRT-PCRreverse transcriptase PCRSARS-CoV-2Severe Acute Respiratory Syndrome coronavirus 2Tmaxtime-to-maximum