PMID- 35584850 OWN - NLM STAT- MEDLINE DCOM- 20220520 LR - 20221207 IS - 2052-4439 (Electronic) IS - 2052-4439 (Linking) VI - 9 IP - 1 DP - 2022 May TI - (129)Xe MRI ventilation defects in ever-hospitalised and never-hospitalised people with post-acute COVID-19 syndrome. LID - 10.1136/bmjresp-2022-001235 [doi] LID - e001235 AB - BACKGROUND: Patients often report persistent symptoms beyond the acute infectious phase of COVID-19. Hyperpolarised (129)Xe MRI provides a way to directly measure airway functional abnormalities; the clinical relevance of (129)Xe MRI ventilation defects in ever-hospitalised and never-hospitalised patients who had COVID-19 has not been ascertained. It remains unclear if persistent symptoms beyond the infectious phase are related to small airways disease and ventilation heterogeneity. Hence, we measured (129)Xe MRI ventilation defects, pulmonary function and symptoms in ever-hospitalised and never-hospitalised patients who had COVID-19 with persistent symptoms consistent with post-acute COVID-19 syndrome (PACS). METHODS: Consenting participants with a confirmed diagnosis of PACS completed (129)Xe MRI, CT, spirometry, multi-breath inert-gas washout, 6-minute walk test, St. George's Respiratory Questionnaire (SGRQ), modified Medical Research Council (mMRC) dyspnoea scale, modified Borg scale and International Physical Activity Questionnaire. Consenting ever-COVID volunteers completed (129)Xe MRI and pulmonary function tests only. RESULTS: Seventy-six post-COVID and nine never-COVID participants were evaluated. Ventilation defect per cent (VDP) was abnormal and significantly greater in ever-COVID as compared with never-COVID participants (p<0.001) and significantly greater in ever-hospitalised compared with never-hospitalised participants who had COVID-19 (p=0.048), in whom diffusing capacity of the lung for carbon-monoxide (p=0.009) and 6-minute walk distance (6MWD) (p=0.005) were also significantly different. (129)Xe MRI VDP was also related to the 6MWD (p=0.02) and post-exertional SpO(2) (p=0.002). Participants with abnormal VDP (>/=4.3%) had significantly worse 6MWD (p=0.003) and post-exertional SpO(2) (p=0.03). CONCLUSION: (129)Xe MRI VDP was significantly worse in ever-hospitalised as compared with never-hospitalised participants and was related to 6MWD and exertional SpO(2) but not SGRQ or mMRC scores. TRIAL REGISTRATION NUMBER: NCT05014516. CI - (c) Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Kooner, Harkiran K AU - Kooner HK AD - Robarts Research Institute, Western University, London, Ontario, Canada. AD - Department of Medical Biophysics, Western University, London, Ontario, Canada. FAU - McIntosh, Marrissa J AU - McIntosh MJ AD - Robarts Research Institute, Western University, London, Ontario, Canada. AD - Department of Medical Biophysics, Western University, London, Ontario, Canada. FAU - Matheson, Alexander M AU - Matheson AM AD - Robarts Research Institute, Western University, London, Ontario, Canada. AD - Department of Medical Biophysics, Western University, London, Ontario, Canada. FAU - Venegas, Carmen AU - Venegas C AD - Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, Ontario, Canada. AD - Division of Respirology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada. FAU - Radadia, Nisarg AU - Radadia N AD - Division of Respirology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada. FAU - Ho, Terence AU - Ho T AD - Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, Ontario, Canada. AD - Division of Respirology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada. FAU - Haider, Ehsan Ahmed AU - Haider EA AD - Department of Radiology, McMaster University, Hamilton, Ontario, Canada. FAU - Konyer, Norman B AU - Konyer NB AD - Imaging Research Centre, St. Joseph's Healthcare, Hamilton, Ontario, Canada. FAU - Santyr, Giles E AU - Santyr GE AD - The Hospital for Sick Children, Toronto, Ontario, Canada. AD - Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada. FAU - Albert, Mitchell S AU - Albert MS AD - Department of Chemistry, Lakehead University, Thunder Bay, Ontario, Canada. AD - Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada. FAU - Ouriadov, Alexei AU - Ouriadov A AUID- ORCID: 0000-0002-0920-2528 AD - Department of Physics and Astronomy, Western University, London, Ontario, Canada. FAU - Abdelrazek, Mohamed AU - Abdelrazek M AD - Department of Medical Imaging, Western University, London, Ontario, Canada. FAU - Kirby, Miranda AU - Kirby M AD - Department of Physics, Ryerson University, Toronto, Ontario, Canada. FAU - Dhaliwal, Inderdeep AU - Dhaliwal I AD - Division of Respirology, Department of Medicine, Western University, London, Ontario, Canada. FAU - Nicholson, J Michael AU - Nicholson JM AUID- ORCID: 0000-0003-1560-7967 AD - Division of Respirology, Department of Medicine, Western University, London, Ontario, Canada. FAU - Nair, Parameswaran AU - Nair P AD - Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, Ontario, Canada. AD - Division of Respirology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada. FAU - Svenningsen, Sarah AU - Svenningsen S AD - Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, Ontario, Canada. AD - Division of Respirology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada. FAU - Parraga, Grace AU - Parraga G AUID- ORCID: 0000-0002-5619-4145 AD - Robarts Research Institute, Western University, London, Ontario, Canada gparraga@robarts.ca. AD - Department of Medical Biophysics, Western University, London, Ontario, Canada. AD - Division of Respirology, Department of Medicine, Western University, London, Ontario, Canada. LA - eng SI - ClinicalTrials.gov/NCT05014516 PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - BMJ Open Respir Res JT - BMJ open respiratory research JID - 101638061 RN - 0 (Xenon Isotopes) SB - IM MH - *COVID-19/complications MH - Humans MH - Magnetic Resonance Imaging MH - *Respiration Disorders MH - Respiratory Function Tests MH - Xenon Isotopes MH - Post-Acute COVID-19 Syndrome PMC - PMC9119175 OTO - NOTNLM OT - COVID-19 OT - Imaging/CT MRI etc COIS- Competing interests: The authors have reported to BMJ Open Respiratory Research the following: TH has received grants from Fisher & Paykel, honoraria for speaking engagements from AstraZeneca, and has participated on advisory boards for Sanofi, AstraZeneca and Valeo, outside the submitted work. JN has received honoraria for speaking engagements from AstraZeneca, Horizon Therapeutics and Vertix, outside the submitted work. PN has received grants from AstraZeneca, Teva, Sanofi, Foresee and Cyclomedica and personal fees from AstraZeneca, Teva, Equillium, Arrowhead Pharma and GlaxoSmithKline, outside the submitted work. SS has received grants from Cyclomedica, personal fees from Arrowhead Pharma and honoraria for speaking engagements from AstraZeneca, Novartis and Polarean, outside the submitted work. GP has received grants from AstraZeneca and Novartis and honoraria for speaking engagements from AstraZeneca, outside the submitted work. GES, MSA, AO, MK, SS and GP received grants from the Ministry of Health and Long-Term Care Ontario related to this work. HKK, MJM, AMM, CV, NR, EAH, NBK, MA and ID have no conflicts to declare. EDAT- 2022/05/19 06:00 MHDA- 2022/05/21 06:00 PMCR- 2022/05/18 CRDT- 2022/05/18 20:33 PHST- 2022/02/23 00:00 [received] PHST- 2022/05/05 00:00 [accepted] PHST- 2022/05/18 20:33 [entrez] PHST- 2022/05/19 06:00 [pubmed] PHST- 2022/05/21 06:00 [medline] PHST- 2022/05/18 00:00 [pmc-release] AID - 9/1/e001235 [pii] AID - bmjresp-2022-001235 [pii] AID - 10.1136/bmjresp-2022-001235 [doi] PST - ppublish SO - BMJ Open Respir Res. 2022 May;9(1):e001235. doi: 10.1136/bmjresp-2022-001235.