Lung perfusion SPECT/CT images associated with COVID-19 - a case series.

Coronavirus disease 2019 (COVID-19) most often presents with mild symptoms, but it can also present with viral pneumonia and acute respiratory distress syndrome, which predispose to thromboembolic disease. There is an increasing number of case studies which report the significance of ventilation/perfusion scintigraphy in the diagnosis of pulmonary embolism in COVID-19 patients [1, 2]. Since most of the patients in Poland were managed in an outpatient setting, this population has been excluded from many studies and its characteristics are not well-documented. Dhawan et al. [3] emphasize the importance of the evaluation of the prevalence and extent of perfusion abnormalities in survivors of COVID-19 through the whole spectrum of illness, from non-hospitalised patients to those in the intensive care unit (ICU). We report a case series of three patients after recovery from COVID-19, who underwent lung perfusion SPECT/CT. Scintigraphic examinations were performed after administration of 99mTc-Makro-Albumon with an activity of about 2 MBq/kg of patient’s body weight. All patients were examined using Symbia Intevo Bold with a protocol including SPECT/CT acquisition with the following parameters: LEHR collimator, 360 degrees, 120 projections, time per projection 15 sec, matrix 128x128; low-dose CT protocol. The examinations were performed to assess lung lesions in these patients. All patients were diagnosed through RT-PCR for SARS-CoV2 and were presenting mild-to-moderate symptoms. Treatment was symptomatic, including paracetamol and ibuprofen in all patients and additional azithromycin in case of Patient 1. None of them required hospitalization. Data and perfusion SPECT/CT findings of the patients are presented in the Table 1 below. Figure 1 and 2 show SPECT/CT findings of Patients 1 and 3, respectively.