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Acta Biomed ; 91(3): ahead of print, 2020 08 10.
Article in English | MEDLINE | ID: covidwho-1389954


Platypnea-orthodeoxia syndrome (POS) is a clinical entity characterized by positional dyspnoea (platypnea) and arterial desaturation (orthodeoxia) that occurs when sitting or standing up and usually resolves by lying down. POS may result from some cardiopulmonary disorders or from other miscellaneous aetiologies. We report a case of POS in a patient after fibrotic evolution of SARS-CoV-2 interstitial pneumonia associated with pulmonary embolism. The patient did not have any evidence of an intracardiac/intrapulmonary shunt.

Betacoronavirus , Coronavirus Infections/complications , Dyspnea/etiology , Lung Diseases, Interstitial/complications , Lung/diagnostic imaging , Pneumonia, Viral/complications , Aged , COVID-19 , Coronavirus Infections/diagnosis , Dyspnea/diagnosis , Female , Humans , Lung Diseases, Interstitial/diagnosis , Pandemics , Pneumonia, Viral/diagnosis , SARS-CoV-2 , Tomography, X-Ray Computed
Eur J Nucl Med Mol Imaging ; 48(9): 2871-2882, 2021 08.
Article in English | MEDLINE | ID: covidwho-1070826


PURPOSE: To assess the presence and pattern of incidental interstitial lung alterations suspicious of COVID-19 on fluorine-18-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) ([18F]FDG PET/CT) in asymptomatic oncological patients during the period of active COVID-19 in a country with high prevalence of the virus. METHODS: This is a multi-center retrospective observational study involving 59 Italian centers. We retrospectively reviewed the prevalence of interstitial pneumonia detected during the COVID period (between March 16 and 27, 2020) and compared to a pre-COVID period (January-February 2020) and a control time (in 2019). The diagnosis of interstitial pneumonia was done considering lung alterations of CT of PET. RESULTS: Overall, [18F]FDG PET/CT was performed on 4008 patients in the COVID period, 19,267 in the pre-COVID period, and 5513 in the control period. The rate of interstitial pneumonia suspicious for COVID-19 was significantly higher during the COVID period (7.1%) compared with that found in the pre-COVID (5.35%) and control periods (5.15%) (p < 0.001). Instead, no significant difference among pre-COVID and control periods was present. The prevalence of interstitial pneumonia detected at PET/CT was directly associated with geographic virus diffusion, with the higher rate in Northern Italy. Among 284 interstitial pneumonia detected during COVID period, 169 (59%) were FDG-avid (average SUVmax of 4.1). CONCLUSIONS: A significant increase of interstitial pneumonia incidentally detected with [18F]FDG PET/CT has been demonstrated during the COVID-19 pandemic. A majority of interstitial pneumonia were FDG-avid. Our results underlined the importance of paying attention to incidental CT findings of pneumonia detected at PET/CT, and these reports might help to recognize early COVID-19 cases guiding the subsequent management.

COVID-19 , Lung Diseases, Interstitial , Fluorodeoxyglucose F18 , Humans , Italy , Lung Diseases, Interstitial/diagnostic imaging , Lung Diseases, Interstitial/epidemiology , Pandemics , Positron Emission Tomography Computed Tomography , Prevalence , Retrospective Studies , SARS-CoV-2
Tumori ; 106(4): 325-332, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-610582


INTRODUCTION: In January 2020, the coronavirus disease 2019 (COVID-19) outbreak in Italy necessitated rigorous application of more restrictive safety procedures in the management and treatment of patients with cancer to ensure patient and staff protection. Identification of respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was a challenge during the pandemic owing to a large number of asymptomatic or mildly symptomatic patients. METHODS: We report 5 patients with unknown SARS-CoV-2 infection undergoing positron emission tomography (PET)/computed tomography (CT) with radiopharmaceuticals targeting different tumor processes: 18F-FDG, 18F-choline (FCH), and 68Ga-PSMA. RESULTS: In all patients, PET/CT showed increased tracer uptake in the lungs corresponding to CT findings of SARS-CoV-2 pneumonia. Quantitative assessment of tracer uptake showed more elevated values for the glucose analogue 18F-FDG (mean SUVmax 5.4) than for the other tracers (mean SUVmax 3.5). CONCLUSIONS: Our findings suggest that PET/CT is a sensitive modality to hypothesize SARS-CoV-2 pneumonia in patients with cancer, even when asymptomatic. More data are needed to verify the correlation among immune response to SARS-CoV-2 infection, clinical evolution, and PET results. Under the strict safety measures implemented at the PET center, the number of potentially SARS-CoV-2-positive patients undergoing PET/CT was very low (1.6%), and no staff member has been diagnosed with infection as of April 30, 2020.

Coronavirus Infections/diagnosis , Neoplasms/diagnosis , Pneumonia, Viral/diagnosis , Pneumonia/diagnosis , Positron Emission Tomography Computed Tomography , Betacoronavirus/pathogenicity , COVID-19 , Contrast Media/therapeutic use , Coronavirus Infections/complications , Coronavirus Infections/therapy , Coronavirus Infections/virology , Disease Outbreaks , Female , Fluorodeoxyglucose F18/therapeutic use , Gallium Isotopes , Gallium Radioisotopes , Humans , Italy/epidemiology , Lung/diagnostic imaging , Lung/pathology , Male , Membrane Glycoproteins/therapeutic use , Neoplasms/complications , Neoplasms/therapy , Neoplasms/virology , Organometallic Compounds/therapeutic use , Pandemics , Pneumonia/complications , Pneumonia/therapy , Pneumonia/virology , Pneumonia, Viral/complications , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Radiopharmaceuticals/therapeutic use , SARS-CoV-2