Is there any change in the muscle uptake pattern of FDGduring or after COVID-19infection in oncological FDGPET-CT patients?

ABSTRACT

Objectives: The coronavirus disease 2019 (COVID-19) is a viral pandemic caused by SARS-CoV-2, a member of the Coronavirinae subfamily. Myalgia is one of the most prevalent symptoms. The aim of this study is to investigatewhether there is a change in FDG uptake of the muscles and bone marrow of patients with COVID-19 infection. Method: From august 2020 to december 2020, a total of 1260 oncological FDG PET-CT studies were performed inour center. Among 242 oncology patients whose SARS-CoV-2 PCR results were available, the data of 32 patients with concurrent SARS-CoV-2 positivity or previous disease history and the data of 36 covid negative patients were analyzed retrospectively. Patients tested positive COVID-19 were divided into 3 groups (14 days, 1 month and 3months) according to the time interval between the active period of the disease and FDG PET-CT imaging. FDGuptake in paraspinal, deltoid, psoas, gluteal muscles and also sacrum of each patient were measured separately, the SUVmax and the SUVmean values were recorded. The FDG uptake in paraspinal, deltoid, psoas, gluteal muscles and sacrum of the covid-negative patient group were measured and recorded the same way as the studygroup. Other imaging findings that may be related to COVID-19 were also noted. Mann-Whitney U-test was used toassess differences in metabolic parameters between the groups. Statistical significance was defined as p<0.05.Patients were asked about their muscle pain in the active phase of the COVID-19 and the pain rating scale used torate the intensity of the pain. Results: Sixty eight patients with a mean age of 56±15 (5-80) years were included in the study. There were 32females and 36 males. Median SUVmean and SUVmax values in the psoas muscle of 15 patients whose timeperiod between the SARS-CoV-2 PCR test positivity and FDG PET-CT imaging was less than 15 days were significantly higher than the median SUVmean and SUVmax values in the psoas muscle of covid-negative patientgroup (p 0.04 and 0.016, respectively). Moreover, the bone marrow SUVmean and SUVmax values obtained from the sacrum were also found to be higher in this group (p 0.036 and 0.016, respectively).In the patient group whosePET-CT imaging was performed 1 month after SARS-CoV-2 PCR test positivity, the SUVmax values obtained from the psoas muscle were significantly higher than the SUVmax values in the covid negative group (p 0.043). There was no significant difference between the SUV parameters obtained from the muscle groups and bone marrow of patients who were tested for SARS-CoV-2 positivity or with a known history of COVID-19, and the SUV parametersobtained from covid-negative patients. Conclusion: Since the disease is new, there are many questions about thecourse of the disease and its early and late findings. Despite being a small sample, in our study, it was shown thatsome COVID-19 patients in the early stage of the disease may show increased FDG uptake in some muscle groups and also in bone marrow.