Beyond the clot: perfusion imaging of the pulmonary vasculature after COVID-19

Autor: Howard Branley, Angelito Vicente, Kavina Manalan, Peter Marsden, Ingrid Wallner, Onn Min Kon, Ranju T. Dhawan, Luke Howard, Surendra Dave, Georgina Russell, Deepa Gopalan, Nishanth Dharmarajah, Mirae Park
Rok vydání: 2021
Předmět:
Pulmonary and Respiratory Medicine
Ventilation-Perfusion Scan
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19)
Computed Tomography Angiography
Hypertension
Pulmonary
Perfusion Imaging
Pulmonary Fibrosis
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Aftercare
Contrast Media
Perfusion scanning
Pulmonary Artery
03 medical and health sciences
Post-Acute COVID-19 Syndrome
0302 clinical medicine
medicine
Humans
030212 general & internal medicine
Intensive care medicine
Lung
Pulmonary thrombosis
Tomography
Emission-Computed
Single-Photon
Personal View
SARS-CoV-2
business.industry
COVID-19
Thrombosis
Triage
Respiratory Function Tests
030228 respiratory system
Chronic Disease
Pulmonary vasculature
Small vessel
Pulmonary Embolism
Tomography
X-Ray Computed
business
Lung tissue
Zdroj: The Lancet. Respiratory Medicine
The Lancet Respiratory Medicine
ISSN: 2213-2600
Popis: 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.
Databáze: OpenAIRE
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