September 20, 2022 – Children and adolescents who have either recovered from COVID-19 or who have had COVID for a long time show persistent lung damage on MRI, according to a study published in Radiology, a journal of the Radiological Society of North America (RSNA).
COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. Since its emergence in late 2019, it has killed more than 5 million people worldwide. The lungs are the primary target of the virus.
The study of the long-term effects of the disease has accelerated as the number of COVID survivors increases and more people are diagnosed with long COVID. The World Health Organization long defines COVID as symptoms lasting at least 12 weeks and other factors, such as B. Symptoms that lead to a new health restriction or worsening of an existing underlying disease.
The nature of the post-acute phase of infection in younger people is poorly understood. CT has shown persistent lung damage in adults, but CT uses ionizing radiation and has limited diagnostic value in children, in whom lung changes due to COVID-19 are less pronounced.
“We designed this study when the evidence for long-term or post-COVID cases in adults was growing,” said study leader Dr. Ferdinand Knieling, Specialist in Pediatrics and Adolescent Medicine at the Departments of Pediatrics and Adolescent Medicine, Erlangen University Hospital Erlangen, Germany. “This is also when the first patients with non-specific symptoms were seen in our unit, and parents began to ask about a link to a previous infection.”
dr Knieling and colleagues studied the effects of COVID-19 in children and adolescents using low-field MRI. The technology relies on a lower magnetic field than traditional MRI and allows for free breathing, meaning subjects do not have to hold their breath during imaging. This makes scanning on children easier to perform.
“As parents, we also wanted to find out what the risks of infection might be,” said Dr. kneeling. “Fortunately, our departments have teamed up to deploy their brand new MRI scanner designed for pediatric screening.”
The researchers examined changes in lung structure and function in 54 children and adolescents (mean age 11 years) with prior SARS-CoV-2 infection. Of the 54 patients, 29 had recovered and 25 had long-term COVID. All but one patient were unvaccinated at the time of initial infection.
None of the COVID-19 group required hospitalization during the primary infection phase. Shortness of breath, trouble paying attention, headache, fatigue and loss of smell were the most commonly reported symptoms at the time of the study. The results of the COVID-19 group were compared to those of nine healthy controls.
MRI allowed the researchers to derive V/Q agreement, a measure of air and blood flow in the lungs. When the lungs are functioning properly, air and blood flow should match.
V/Q matches demonstrated persistent pulmonary dysfunction in patients who had recovered from COVID-19 and in those with long COVID. The V/Q agreement was 62% in the recovered group and 60% in the long COVID group – both significantly lower than the 81% agreement in healthy controls.
“Persistent post-COVID symptoms still cause diagnostic odysseys, and this is especially true for young people,” said Dr. kneeling. “Our results show that the care of these patients is a multidisciplinary challenge.”
The long-term effects of these lung changes remain unclear, but the findings warrant further monitoring of persistent lung damage in children and adolescents post-COVID-19, said Dr. kneeling. Lung MRI is already widely used, he noted, making these imaging approaches easy to integrate into routine clinical care. Further research will help demonstrate the full potential of MRI in COVID-19 survivors.
“A follow-up study has already begun, and we’re trying to understand how the results are changing over time,” said Dr. kneeling. “We will also look more closely at other organs to see how this correlates with our findings.”
For more information: www.rsna.org
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