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Lung Perfusion Scintigraphy Early After COVID-19: A Single-Center Retrospective Study.

Authors
  • Sajal, De1
  • Mudalsha, Ravina2
  • Tinu, Lukose2
  • Ranganath, T Ganga3
  • Dibakar, Sahu3
  • 1 Department of Pulmonary Medicine, All India Institute of Medical Sciences, Raipur, India; and [email protected]. , (India)
  • 2 Department of Nuclear Medicine, All India Institute of Medical Sciences, Raipur, India. , (India)
  • 3 Department of Pulmonary Medicine, All India Institute of Medical Sciences, Raipur, India; and. , (India)
Type
Published Article
Journal
Journal of Nuclear Medicine Technology
Publisher
Society of Nuclear Medicine
Publication Date
Dec 01, 2021
Volume
49
Issue
4
Pages
320–323
Identifiers
DOI: 10.2967/jnmt.121.262440
PMID: 34330803
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The incidence of thromboembolic complications in coronavirus disease 2019 (COVID-19) infection is well recognized. The present study retrospectively evaluated the type and prevalence of lung perfusion defects in early-post-COVID-19 patients with hypoxia and was aimed to identify the risk factors for mismatched perfusion defects. Methods: We analyzed SPECT/CT images of 54 early-post-COVID-19 patients (44 men and 10 women). Logistic regression analysis was used to examine the risk. Results: The mean age of the study population was 55.4 y (range, 34-76 y). All received prophylactic anticoagulation from the day of hospitalization to the date of perfusion scanning. The median interval between COVID-19-positive reports and lung perfusion scanning was 22 d. Lung perfusion defects (of any type) were observed in most (87%). Twenty-three subjects (42.6%) had mismatched perfusion defects. Mismatched perfusion defects were segmental in 14 subjects (25.9%) and subsegmental in 11 (20.4%). Higher age was a risk factor for mismatched perfusion defects (odds ratio, 1.06; 95% CI, 0.99-1.13; P = 0.06). Subjects with a serum D-dimer level of at least 2,500 ng/mL on the day before the scan were not at higher risk for having mismatched perfusion defects (odds ratio, 1.14; 95% CI, 0.34-3.9; P = 0.83). Conclusion: Despite prophylactic anticoagulation, mismatched perfusion defects suggestive of pulmonary thromboembolism were observed. Serum D-dimer level in patients early after COVID-19 is a poor predictor of mismatched perfusion defects. Confirmed evidence of pulmonary embolism by imaging studies should support the decision to extend anticoagulant prophylaxis in post-COVID-19 patients. © 2021 by the Society of Nuclear Medicine and Molecular Imaging.

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