長期のCOVIDは心臓と肺に長期的な変化を引き起こし、心疾患と肺疾患につながる可能性がある(Long COVID May Cause Long-Term Changes in the Heart and Lungs and May Lead to Cardiac and Pulmonary Diseases)

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2025-05-06 マウントサイナイ医療システム (MSHS)

長期のCOVIDは心臓と肺に長期的な変化を引き起こし、心疾患と肺疾患につながる可能性がある(Long COVID May Cause Long-Term Changes in the Heart and Lungs and May Lead to Cardiac and Pulmonary Diseases)

マウントサイナイ医科大学の研究チームは、ロングCOVID(新型コロナウイルス感染後症候群)が心臓および肺に長期的な炎症を引き起こし、将来的な心肺疾患のリスクを高める可能性があることを明らかにしました。この研究では、先進的なPET/MRI画像診断技術を用いて、ロングCOVID患者の心肺組織における異常や循環免疫調節タンパク質の変化を検出しました。これらの異常は、心不全、弁膜症、肺高血圧症などの疾患の早期警告サインとなる可能性があります。研究者は、SARS-CoV-2感染が心血管および肺の健康に長期的な影響を及ぼすことを強調し、感染予防の重要性を訴えています。

<関連情報>

長期COVID患者におけるPET/MRIおよびDECT画像上の持続的な心血管および肺の異常の有病率 Prevalence of Persistent Cardiovascular and Pulmonary Abnormalities on PET/MRI and DECT Imaging in Long COVID Patients

Maria Giovanna Trivieri, Ana Devesa, Philip M. Robson, Sonali Bose, Busra Cangut, Steve Liao, Audrey Kaufman, Renata Pyzik, Valentin Fauveau, Jamie Wood, Aaron Shpiner, Edwin Yoo, Sarayu Huang, Claudia Calcagno, Venkatesh Mani, Sahityasri Thapi, Johanna Contreras, Kai Nie, Seunghee Kim-Schulze, Sacha Gnjatic, Miriam Merad, Munir Ghesani, David Putrino, Adam Jacobi, Donna Mancini, Charles Powell and Zahi A. Fayad
Journal of Nuclear Medicine  Published:April 30, 2025
DOI:https://doi.org/10.2967/jnumed.124.268980

Abstract

The objective of this study is to describe the prevalence of inflammatory cardiopulmonary findings in a prospective cohort of long coronavirus disease (LC) patients.

Methods: Subjects with a history of coronavirus disease 2019 infection, persistent cardiopulmonary symptoms 9–12 mo after initial infection, and a clinical assessment compatible with LC underwent cardiopulmonary 18F-FDG PET/MRI, dual-energy CT (DECT) of the lungs, and plasma protein analysis (subgroup). A control group that included subjects with a history of acute severe acute respiratory syndrome coronavirus 2 infection but without cardiopulmonary symptoms at recruitment was also characterized.

Results: Ninety-eight patients (median age, 48.5 y; 47% men) were enrolled. The most common LC symptom was shortness of breath (80%), and 27% of participants were hospitalized. Of the subjects, 90% presented abnormalities in DECT, with 67% and 59% of participants demonstrating pulmonary infiltrates and abnormal perfusion, respectively. PET/MRI was abnormal for 57% of subjects: 24% showed cardiac involvement suggestive of myocarditis, 22% presented uptake reminiscent of pericarditis, 11% showed periannular uptake, and 30% showed vascular uptake (aortic or pulmonary). There was no myocardial, pericardial, periannular, or pulmonary uptake on the PET/MRI scans of the control group (n = 9). Analysis of plasma protein concentrations showed significant differences between the LC and the control groups. Lastly, the plasma protein profile was significantly different among LC patients with abnormal and normal PET/MRI.

Conclusion: In LC subjects evaluated up to a year after coronavirus disease 2019 infection, our results indicate a high prevalence of abnormalities on PET/MRI and DECT, as well as significant differences in the peripheral biomarker profile, which might warrant further monitoring to exclude the development of complications such as pulmonary hypertension and valvular disease.

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