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Beyond the clot: perfusion imaging of the pulmonary vasculature after COVID-19.
Dhawan, Ranju T; Gopalan, Deepa; Howard, Luke; Vicente, Angelito; Park, Mirae; Manalan, Kavina; Wallner, Ingrid; Marsden, Peter; Dave, Surendra; Branley, Howard; Russell, Georgina; Dharmarajah, Nishanth; Kon, Onn M.
  • Dhawan RT; Department of Radiology, Imperial College Healthcare NHS Trust, London, UK; Hybrid Imaging and Therapy Unit, The Wellington Hospital, HCA Healthcare, London, UK. Electronic address: ranju.dhawan@nhs.net.
  • Gopalan D; Department of Radiology, Imperial College Healthcare NHS Trust, London, UK; National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, UK; Hybrid Imaging and Therapy Unit, The Wellington Hospital, HCA Healthcare, London, UK.
  • Howard L; Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK; National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, UK; National Heart and Lung Institute, Imperial College London, London, UK.
  • Vicente A; Hybrid Imaging and Therapy Unit, The Wellington Hospital, HCA Healthcare, London, UK.
  • Park M; Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK; National Heart and Lung Institute, Imperial College London, London, UK.
  • Manalan K; Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK; National Heart and Lung Institute, Imperial College London, London, UK.
  • Wallner I; Hybrid Imaging and Therapy Unit, The Wellington Hospital, HCA Healthcare, London, UK.
  • Marsden P; Hybrid Imaging and Therapy Unit, The Wellington Hospital, HCA Healthcare, London, UK; Medical Physics and Biomedical Engineering, University College London Hospitals, London, UK.
  • Dave S; Hybrid Imaging and Therapy Unit, The Wellington Hospital, HCA Healthcare, London, UK.
  • Branley H; Respiratory Unit, The Wellington Hospital, HCA Healthcare, London, UK.
  • Russell G; Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK.
  • Dharmarajah N; Hybrid Imaging and Therapy Unit, The Wellington Hospital, HCA Healthcare, London, UK.
  • Kon OM; Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK; National Heart and Lung Institute, Imperial College London, London, UK.
Lancet Respir Med ; 9(1): 107-116, 2021 01.
Article in English | MEDLINE | ID: covidwho-939393
ABSTRACT
A compelling body of evidence points to pulmonary thrombosis and thromboembolism as a key feature of COVID-19. As the pandemic spread across the globe over the past few months, a timely call to arms was issued by a team of clinicians to consider the prospect of long-lasting pulmonary fibrotic damage and plan for structured follow-up. However, the component of post-thrombotic sequelae has been less widely considered. Although the long-term outcomes of COVID-19 are not known, should pulmonary vascular sequelae prove to be clinically significant, these have the potential to become a public health problem. In this Personal View, we propose a proactive follow-up strategy to evaluate residual clot burden, small vessel injury, and potential haemodynamic sequelae. A nuanced and physiological approach to follow-up imaging that looks beyond the clot, at the state of perfusion of lung tissue, is proposed as a key triage tool, with the potential to inform therapeutic strategies.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Artery / Pulmonary Embolism / Pulmonary Fibrosis / Thrombosis / Computed Tomography Angiography / Ventilation-Perfusion Scan / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Lancet Respir Med Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pulmonary Artery / Pulmonary Embolism / Pulmonary Fibrosis / Thrombosis / Computed Tomography Angiography / Ventilation-Perfusion Scan / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Lancet Respir Med Year: 2021 Document Type: Article