{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T06:29:31Z","timestamp":1762928971810,"version":"3.41.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Clin Nucl Med"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>We quantified lung glycolytic metabolic activity, clinical symptoms and inflammation, coagulation, and endothelial activation biomarkers in 2019 coronavirus disease (COVID-19) pneumonia survivors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Adults previously hospitalized with moderate to severe COVID-19 pneumonia were prospectively included. Subjects filled out a questionnaire on clinical consequences, underwent chest CT and <jats:sup>18<\/jats:sup>F-FDG PET\/CT, and provided blood samples on the same day. Forty-five volunteers served as control subjects. Analysis of CT images and quantitative voxel-based analysis of PET\/CT images were performed for both groups. <jats:sup>18<\/jats:sup>F-FDG uptake in the whole-lung volume and in high- and low-attenuation areas was calculated and normalized to liver values. Quantification of plasma markers of inflammation (interleukin 6), <jats:sc>d<\/jats:sc>-dimer, and endothelial cell activation (angiopoietins 1 and 2, vascular cell adhesion molecule 1, and intercellular adhesion molecule 1) was also performed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We enrolled 53 COVID-19 survivors (62.3% were male; median age, 50 years). All survivors reported at least 1 persistent symptom, and 41.5% reported more than 6 symptoms. The mean lung density was greater in survivors than in control subjects, and more metabolic activity was observed in normal and dense lung areas, even months after symptom onset. Plasma proinflammatory, coagulation, and endothelial activation biomarker concentrations were also significantly higher in survivors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>We observed more metabolic activity in areas of high and normal lung attenuation several months after moderate to severe COVID-19 pneumonia. In addition, plasma markers of thromboinflammation and endothelial activation persisted. These findings may have implications for our understanding of the in vivo pathogenesis and long-lasting effects of COVID-19 pneumonia.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/rlu.0000000000004376","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T20:01:02Z","timestamp":1661544062000},"page":"1019-1025","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Increased Lung Immune Metabolic Activity in COVID-19 Survivors"],"prefix":"10.1097","volume":"47","author":[{"given":"Rosana Souza","family":"Rodrigues","sequence":"first","affiliation":[]},{"given":"Gabriel","family":"Motta Ribeiro","sequence":"additional","affiliation":[{"name":"Laboratory of Pulmonary Engineering, Biomedical Engineering Program, Alberto Luiz Coimbra Institute of Post-Graduation and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil"}]},{"given":"Miriam Menna","family":"Barreto","sequence":"additional","affiliation":[{"name":"Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil"}]},{"given":"Walter Araujo","family":"Zin","sequence":"additional","affiliation":[{"name":"Laboratory of Respiration Physiology, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro"}]},{"given":"J\u00falia","family":"de Toledo-Mendes","sequence":"additional","affiliation":[{"name":"Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil"}]},{"given":"Philippe Alcantara G.","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil"}]},{"given":"Sergio Altino","family":"de Almeida","sequence":"additional","affiliation":[{"name":"D'Or Institute for Research and Education, Rio de Janeiro, Brazil"}]},{"given":"Rodrigo","family":"Bas\u00edlio","sequence":"additional","affiliation":[{"name":"D'Or Institute for Research and Education, Rio de Janeiro, Brazil"}]},{"given":"Remy","family":"Martins-Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro"}]},{"given":"Eug\u00eanio Damaceno","family":"Hottz","sequence":"additional","affiliation":[]},{"given":"Patricia T.","family":"Bozza","sequence":"additional","affiliation":[{"name":"Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro"}]},{"given":"Fernando A.","family":"Bozza","sequence":"additional","affiliation":[]},{"given":"Alysson Roncally Silva","family":"Carvalho","sequence":"additional","affiliation":[]},{"given":"Paulo Henrique","family":"Rosado-de-Castro","sequence":"additional","affiliation":[]}],"member":"276","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"bib2-20250621","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1001\/jama.2020.12603","article-title":"Persistent symptoms in patients after acute COVID-19","volume":"324","year":"2020","journal-title":"JAMA"},{"key":"bib3-20250621","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post\u2013acute COVID-19 syndrome","volume":"27","year":"2021","journal-title":"Nat Med"},{"key":"bib4-20250621","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1016\/S2213-2600(21)00378-7","article-title":"Pathological disease in the lung periphery after acute COVID-19","volume":"9","year":"2021","journal-title":"Lancet Respir Med"},{"key":"bib5-20250621","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1148\/radiol.2021211746","article-title":"CT lung abnormalities after COVID-19 at 3 months and 1 year after hospital discharge","volume":"303","year":"2022","journal-title":"Radiology"},{"key":"bib6-20250621","doi-asserted-by":"crossref","first-page":"E177","DOI":"10.1148\/radiol.2021203153","article-title":"Six-month follow-up chest CT findings after severe COVID-19 pneumonia","volume":"299","year":"2021","journal-title":"Radiology"},{"key":"bib7-20250621","doi-asserted-by":"crossref","first-page":"109676","DOI":"10.1016\/j.ejrad.2021.109676","article-title":"Post-discharge chest CT findings and pulmonary function tests in severe COVID-19 patients","volume":"138","year":"2021","journal-title":"Eur J Radiol"},{"key":"bib8-20250621","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.nucmedbio.2017.01.005","article-title":"18F-fluoro-2-deoxyglucose PET informs neutrophil accumulation and activation in lipopolysaccharide-induced acute lung injury","volume":"48","year":"2017","journal-title":"Nucl Med Biol"},{"key":"bib9-20250621","doi-asserted-by":"crossref","first-page":"e192","DOI":"10.1016\/S1473-3099(20)30483-7","article-title":"A minimal common outcome measure set for COVID-19 clinical research","volume":"20","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"bib10-20250621","doi-asserted-by":"crossref","first-page":"100186","DOI":"10.1016\/j.lanepe.2021.100186","article-title":"Long COVID in adults discharged from UK hospitals after COVID-19: a prospective, multicentre cohort study using the ISARIC WHO clinical characterisation protocol","volume":"8","year":"2021","journal-title":"Lancet Reg Health Eur"},{"key":"bib11-20250621","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1148\/radiol.2462070712","article-title":"Fleischner Society: glossary of terms for thoracic imaging","volume":"246","year":"2008","journal-title":"Radiology"},{"key":"bib12-20250621","doi-asserted-by":"crossref","first-page":"11336","DOI":"10.1038\/s41598-020-68057-4","article-title":"Different computed tomography patterns of coronavirus disease 2019 (COVID-19) between survivors and non-survivors","volume":"10","year":"2020","journal-title":"Sci Rep"},{"key":"bib13-20250621","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s41747-020-00173-2","article-title":"Automatic lung segmentation in routine imaging is primarily a data diversity problem, not a methodology problem","volume":"4","year":"2020","journal-title":"Eur Radiol Exp"},{"key":"bib14-20250621","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/RTI.0b013e31829f6796","article-title":"Development of quantitative computed tomography lung protocols","volume":"28","year":"2013","journal-title":"J Thorac Imaging"},{"key":"bib15-20250621","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1016\/j.acra.2019.12.022","article-title":"Inflammatory activity in atelectatic and normally aerated regions during early acute lung injury","volume":"27","year":"2020","journal-title":"Acad Radiol"},{"key":"bib16-20250621","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1038\/s41586-020-2588-y","article-title":"Longitudinal analyses reveal immunological misfiring in severe COVID-19","volume":"584","year":"2020","journal-title":"Nature"},{"key":"bib17-20250621","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1111\/jth.14859","article-title":"d-Dimer levels on admission to predict in-hospital mortality in patients with COVID-19","volume":"18","year":"2020","journal-title":"J Thromb Haemost"},{"key":"bib18-20250621","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1007\/s10456-020-09730-0","article-title":"Angiopoietin-2 as a marker of endothelial activation is a good predictor factor for intensive care unit admission of COVID-19 patients","volume":"23","year":"2020","journal-title":"Angiogenesis"},{"key":"bib19-20250621","doi-asserted-by":"crossref","first-page":"e210830","DOI":"10.1001\/jamanetworkopen.2021.0830","article-title":"Sequelae in adults at 6 months after COVID-19 infection","volume":"4","year":"2021","journal-title":"JAMA Netw Open"},{"key":"bib20-20250621","doi-asserted-by":"crossref","first-page":"210185","DOI":"10.1183\/16000617.0185-2021","article-title":"Post\u2013acute COVID-19 syndrome","volume":"31","year":"2022","journal-title":"Eur Respir Rev"},{"key":"bib21-20250621","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/S2213-2600(21)00174-0","article-title":"3-Month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19\u2013related hospitalisation: a prospective study","volume":"9","year":"2021","journal-title":"Lancet Respir Med"},{"key":"bib22-20250621","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/S0140-6736(20)32656-8","article-title":"6-Month consequences of COVID-19 in patients discharged from hospital: a cohort study","volume":"397","year":"2021","journal-title":"Lancet"},{"key":"bib23-20250621","doi-asserted-by":"crossref","first-page":"E383","DOI":"10.1148\/radiol.2021211396","article-title":"CT of post-acute lung complications of COVID-19","volume":"301","year":"2021","journal-title":"Radiology"},{"key":"bib24-20250621","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1148\/rg.2020200159","article-title":"Chest CT in COVID-19: what the radiologist needs to know","volume":"40","year":"2020","journal-title":"Radiographics"},{"key":"bib25-20250621","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1136\/thoraxjnl-2020-216308","article-title":"A prospective study of 12-week respiratory outcomes in COVID-19\u2013related hospitalisations","volume":"76","year":"2021","journal-title":"Thorax"},{"key":"bib26-20250621","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1001\/jama.2021.3331","article-title":"Four-month clinical status of a cohort of patients after hospitalization for COVID-19","volume":"325","year":"2021","journal-title":"JAMA"},{"key":"bib27-20250621","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1053\/j.semnuclmed.2021.06.017","article-title":"FDG-PET\/CT of COVID-19 and other lung infections","volume":"52","year":"2022","journal-title":"Semin Nucl Med"},{"key":"bib28-20250621","doi-asserted-by":"crossref","first-page":"2703","DOI":"10.1007\/s00259-020-04958-w","article-title":"FDG PET\/CT evaluation of a patient recovering from COVID-19","volume":"47","year":"2020","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"bib29-20250621","doi-asserted-by":"crossref","first-page":"e00869","DOI":"10.1016\/j.idcr.2020.e00869","article-title":"[18F]FDG-PET\/CT in different COVID-19 phases","volume":"21","year":"2020","journal-title":"IDCases"},{"key":"bib30-20250621","doi-asserted-by":"crossref","first-page":"2531","DOI":"10.1007\/s00259-020-05083-4","article-title":"Inflammatory response in lungs and extrapulmonary sites detected by [18F] fluorodeoxyglucose PET\/CT in convalescing COVID-19 patients tested negative for coronavirus","volume":"48","year":"2021","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"bib31-20250621","doi-asserted-by":"crossref","first-page":"270","DOI":"10.2967\/jnumed.121.262296","article-title":"Evolution of 18F-FDG PET\/CT findings in patients after COVID-19: an initial investigation","volume":"63","year":"2022","journal-title":"J Nucl Med"},{"key":"bib32-20250621","doi-asserted-by":"crossref","first-page":"3187","DOI":"10.1007\/s00259-021-05294-3","article-title":"Long COVID hallmarks on [18F]FDG-PET\/CT: a case-control study","volume":"48","year":"2021","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"bib33-20250621","doi-asserted-by":"crossref","first-page":"2273","DOI":"10.1007\/s00134-008-1220-7","article-title":"FDG-PET in patients at risk for acute respiratory distress syndrome: a preliminary report","volume":"34","year":"2008","journal-title":"Intensive Care Med"},{"key":"bib34-20250621","doi-asserted-by":"crossref","first-page":"292","DOI":"10.2214\/AJR.10.4499","article-title":"Assessment of lung inflammation with 18F-FDG PET during acute lung injury","volume":"195","year":"2010","journal-title":"AJR Am J Roentgenol"},{"key":"bib35-20250621","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s00259-013-2514-8","article-title":"Areas of normal pulmonary parenchyma on HRCT exhibit increased FDG PET signal in IPF patients","volume":"41","year":"2014","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"bib36-20250621","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1164\/rccm.201201-0051OC","article-title":"Assessment of pulmonary neutrophilic inflammation in emphysema by quantitative positron emission tomography","volume":"186","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"key":"bib37-20250621","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1097\/RLU.0b013e3181b539f7","article-title":"Influenza-like infection can result in diffuse fluordeoxyglucose uptake in the lungs","volume":"34","year":"2009","journal-title":"Clin Nucl Med"},{"key":"bib38-20250621","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1161\/CIRCULATIONAHA.120.048488","article-title":"Immunothrombotic dysregulation in COVID-19 pneumonia is associated with respiratory failure and coagulopathy","volume":"142","year":"2020","journal-title":"Circulation"},{"key":"bib39-20250621","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1056\/NEJMoa2015432","article-title":"Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in COVID-19","volume":"383","year":"2020","journal-title":"N Engl J Med"},{"key":"bib40-20250621","doi-asserted-by":"crossref","first-page":"e575","DOI":"10.1016\/S2352-3026(20)30216-7","article-title":"Endotheliopathy in COVID-19\u2013associated coagulopathy: evidence from a single-centre, cross-sectional study","volume":"7","year":"2020","journal-title":"Lancet Haematol"}],"container-title":["Clinical Nuclear Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/RLU.0000000000004376","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T20:05:20Z","timestamp":1750536320000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/RLU.0000000000004376"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,26]]},"references-count":39,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/rlu.0000000000004376","relation":{},"ISSN":["1536-0229","0363-9762"],"issn-type":[{"type":"electronic","value":"1536-0229"},{"type":"print","value":"0363-9762"}],"subject":[],"published":{"date-parts":[[2022,8,26]]}}}