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Pulmonary Dysfunction after Pediatric COVID-19
BACKGROUND: Long COVID occurs at a lower frequency in children and adolescents than in adults. Morphologic and free-breathing phase-resolved functional low-field-strength MRI may help identify persistent pulmonary manifestations after SARS-CoV-2 infection. PURPOSE: To characterize both morphologic a...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Radiological Society of North America
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9513839/ https://www.ncbi.nlm.nih.gov/pubmed/36125379 http://dx.doi.org/10.1148/radiol.221250 |
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author | Heiss, Rafael Tan, Lina Schmidt, Sandy Regensburger, Adrian P. Ewert, Franziska Mammadova, Dilbar Buehler, Adrian Vogel-Claussen, Jens Voskrebenzev, Andreas Rauh, Manfred Rompel, Oliver Nagel, Armin M. Lévy, Simon Bickelhaupt, Sebastian May, Matthias S. Uder, Michael Metzler, Markus Trollmann, Regina Woelfle, Joachim Wagner, Alexandra L. Knieling, Ferdinand |
author_facet | Heiss, Rafael Tan, Lina Schmidt, Sandy Regensburger, Adrian P. Ewert, Franziska Mammadova, Dilbar Buehler, Adrian Vogel-Claussen, Jens Voskrebenzev, Andreas Rauh, Manfred Rompel, Oliver Nagel, Armin M. Lévy, Simon Bickelhaupt, Sebastian May, Matthias S. Uder, Michael Metzler, Markus Trollmann, Regina Woelfle, Joachim Wagner, Alexandra L. Knieling, Ferdinand |
author_sort | Heiss, Rafael |
collection | PubMed |
description | BACKGROUND: Long COVID occurs at a lower frequency in children and adolescents than in adults. Morphologic and free-breathing phase-resolved functional low-field-strength MRI may help identify persistent pulmonary manifestations after SARS-CoV-2 infection. PURPOSE: To characterize both morphologic and functional changes of lung parenchyma at low-field-strength MRI in children and adolescents with post–COVID-19 condition compared with healthy controls. MATERIALS AND METHODS: Between August and December 2021, a cross-sectional clinical trial using low-field-strength MRI was performed in children and adolescents from a single academic medical center. The primary outcome was the frequency of morphologic changes at MRI. Secondary outcomes included MRI-derived functional proton ventilation and perfusion parameters. Clinical symptoms, the duration from positive reverse transcriptase–polymerase chain reaction test result, and serologic parameters were compared with imaging results. Nonparametric tests for pairwise and corrected tests for groupwise comparisons were applied to assess differences in healthy controls, recovered participants, and those with long COVID. RESULTS: A total of 54 participants after COVID-19 infection (mean age, 11 years ± 3 [SD]; 30 boys [56%]) and nine healthy controls (mean age, 10 years ± 3; seven boys [78%]) were included: 29 (54%) in the COVID-19 group had recovered from infection and 25 (46%) were classified as having long COVID on the day of enrollment. Morphologic abnormality was identified in one recovered participant. Both ventilated and perfused lung parenchyma (ventilation-perfusion [V/Q] match) was higher in healthy controls (81% ± 6.1) compared with the recovered group (62% ± 19; P = .006) and the group with long COVID (60% ± 20; P = .003). V/Q match was lower in patients with time from COVID-19 infection to study participation of less than 180 days (63% ± 20; P = .03), 180–360 days (63% ± 18; P = .03), and 360 days (41% ± 12; P < .001) as compared with the never-infected healthy controls (81% ± 6.1). CONCLUSION: Low-field-strength MRI showed persistent pulmonary dysfunction in children and adolescents who recovered from COVID-19 and those with long COVID. Clinical trial registration no. NCT04990531 © RSNA, 2022 Supplemental material is available for this article. See also the editorial by Paltiel in this issue. |
format | Online Article Text |
id | pubmed-9513839 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Radiological Society of North America |
record_format | MEDLINE/PubMed |
spelling | pubmed-95138392022-09-27 Pulmonary Dysfunction after Pediatric COVID-19 Heiss, Rafael Tan, Lina Schmidt, Sandy Regensburger, Adrian P. Ewert, Franziska Mammadova, Dilbar Buehler, Adrian Vogel-Claussen, Jens Voskrebenzev, Andreas Rauh, Manfred Rompel, Oliver Nagel, Armin M. Lévy, Simon Bickelhaupt, Sebastian May, Matthias S. Uder, Michael Metzler, Markus Trollmann, Regina Woelfle, Joachim Wagner, Alexandra L. Knieling, Ferdinand Radiology Original Research BACKGROUND: Long COVID occurs at a lower frequency in children and adolescents than in adults. Morphologic and free-breathing phase-resolved functional low-field-strength MRI may help identify persistent pulmonary manifestations after SARS-CoV-2 infection. PURPOSE: To characterize both morphologic and functional changes of lung parenchyma at low-field-strength MRI in children and adolescents with post–COVID-19 condition compared with healthy controls. MATERIALS AND METHODS: Between August and December 2021, a cross-sectional clinical trial using low-field-strength MRI was performed in children and adolescents from a single academic medical center. The primary outcome was the frequency of morphologic changes at MRI. Secondary outcomes included MRI-derived functional proton ventilation and perfusion parameters. Clinical symptoms, the duration from positive reverse transcriptase–polymerase chain reaction test result, and serologic parameters were compared with imaging results. Nonparametric tests for pairwise and corrected tests for groupwise comparisons were applied to assess differences in healthy controls, recovered participants, and those with long COVID. RESULTS: A total of 54 participants after COVID-19 infection (mean age, 11 years ± 3 [SD]; 30 boys [56%]) and nine healthy controls (mean age, 10 years ± 3; seven boys [78%]) were included: 29 (54%) in the COVID-19 group had recovered from infection and 25 (46%) were classified as having long COVID on the day of enrollment. Morphologic abnormality was identified in one recovered participant. Both ventilated and perfused lung parenchyma (ventilation-perfusion [V/Q] match) was higher in healthy controls (81% ± 6.1) compared with the recovered group (62% ± 19; P = .006) and the group with long COVID (60% ± 20; P = .003). V/Q match was lower in patients with time from COVID-19 infection to study participation of less than 180 days (63% ± 20; P = .03), 180–360 days (63% ± 18; P = .03), and 360 days (41% ± 12; P < .001) as compared with the never-infected healthy controls (81% ± 6.1). CONCLUSION: Low-field-strength MRI showed persistent pulmonary dysfunction in children and adolescents who recovered from COVID-19 and those with long COVID. Clinical trial registration no. NCT04990531 © RSNA, 2022 Supplemental material is available for this article. See also the editorial by Paltiel in this issue. Radiological Society of North America 2022-09-20 /pmc/articles/PMC9513839/ /pubmed/36125379 http://dx.doi.org/10.1148/radiol.221250 Text en © 2023 by the Radiological Society of North America, Inc. This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections. |
spellingShingle | Original Research Heiss, Rafael Tan, Lina Schmidt, Sandy Regensburger, Adrian P. Ewert, Franziska Mammadova, Dilbar Buehler, Adrian Vogel-Claussen, Jens Voskrebenzev, Andreas Rauh, Manfred Rompel, Oliver Nagel, Armin M. Lévy, Simon Bickelhaupt, Sebastian May, Matthias S. Uder, Michael Metzler, Markus Trollmann, Regina Woelfle, Joachim Wagner, Alexandra L. Knieling, Ferdinand Pulmonary Dysfunction after Pediatric COVID-19 |
title | Pulmonary Dysfunction after Pediatric COVID-19 |
title_full | Pulmonary Dysfunction after Pediatric COVID-19 |
title_fullStr | Pulmonary Dysfunction after Pediatric COVID-19 |
title_full_unstemmed | Pulmonary Dysfunction after Pediatric COVID-19 |
title_short | Pulmonary Dysfunction after Pediatric COVID-19 |
title_sort | pulmonary dysfunction after pediatric covid-19 |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9513839/ https://www.ncbi.nlm.nih.gov/pubmed/36125379 http://dx.doi.org/10.1148/radiol.221250 |
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