Follow-Up of a Cohort of Patients with Post-Acute COVID-19 Syndrome in a Belgian Family Practice, 2022, Jamoulle et al

Abstract

Fifty-five patients who suffered from COVID-19, who were still very ill after several months, with extreme fatigue, effort exhaustion, brain fog, anomia, memory disorder, anosmia, dysgeusia, and other multi-systemic health problems have been followed in a family practice setting between May 2021 and July 2022. Data extracted from the medical records of the 55 patients (40 women), mean age 42.4 (12 to 79 years), and a qualitative study of 6 of them using a semi-open-ended questionnaire allowed to highlight the clinical picture described by WHO as post-acute COVID-19 syndrome (PACS) also known as long COVID.

We used brain single-photon emission computed tomography (SPECT-CT) in thirty-two patients with a high severity index and a highly impaired functional status, demonstrating vascular encephalopathy in twenty nine patients and supporting the hypothesis of a persistent cerebral vascular flow disorder in post COVID-19 condition. The patients will benefit from the consortium COVID Human Genetic Effort (covidhge.com) to explore the genetic and immunological basis of their problem, as 23/55 cases don’t have immunological certainty of a COVID-19 infection. There is no known verified treatment.

Analyzing the data from the first 52 patients, three categories of patients emerged over time: 16 patients made a full recovery after 6–8 months, 15 patients were able to return to life and work after 12–18 months with some sequelae, both groups being considered cured. In the third group, 21 patients are still very ill and unable to resume their work and life after 18 months.

The biopsychosocial consequences on patients’ lives are severe and family doctors are left out in the cold. It is necessary to test the reproducibility of this description, conducted on a small number of patients. Nevertheless, identifying, monitoring and supporting these patients is a necessity in family medicine.

Open access, https://www.mdpi.com/1999-4915/14/9/2000/htm

 

Same author, looks like an abstract for a presentation at Demystifying Long Covid 2023 conference:

Single-photon emission computed tomography facilitates the diagnosis of vascular encephalitis in cases of severe Long Covid and correlates with transcriptomic studies, 2023, Jamoulle et al

So what is going on with SPECT? I know there's controversy about its diagnostic ability, but the above seems promising for long COVID. Is there good evidence that it is not a promising biomarker or diagnostic tool, at least in severe folk, as described in the above two sources?

 

Interesting. Here's a bit more from the first paper on PET:

That's interesting that PET was much less sensitive:

I'm not sure why the poster says 45 but the abstract says 48, though:

 

hmmm