Assessment of Ventilation and Perfusion in Patients with COVID-19 Discloses Unique Information of Pulmonary Function to a Clinician: Case Reports of V/P SPECT

Marika Bajc; Fredrik Hedeer; Ari Lindqvist; Elin Trägårdh

doi:10.1177/11795484211030159

Assessment of Ventilation and Perfusion in Patients with COVID-19 Discloses Unique Information of Pulmonary Function to a Clinician: Case Reports of V/P SPECT

Clin Med Insights Circ Respir Pulm Med. 2021 Jul 20:15:11795484211030159. doi: 10.1177/11795484211030159. eCollection 2021.

Authors

Marika Bajc¹, Fredrik Hedeer¹, Ari Lindqvist², Elin Trägårdh³

Affiliations

¹ Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital Lund, 22185, Lund, Sweden.
² Research Unit of Pulmonary Diseases, Clinical Research Institute HUCH Ltd., Helsinki University Hospital HUS and Helsinki University, Helsinki, Finland.
³ Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital Malmö, Lund University, Lund, Sweden.

Abstract

V/P SPECT from 4 consecutive patients with COVID-19 suggests that ventilation and perfusion images may be applied to diagnose or exclude pulmonary embolism, verify nonsegmental diversion of perfusion from the ventilated areas (dead space ventilation) that may represent inflammation of the pulmonary vasculature, detect the reversed mismatch of poor ventilation and better preserved perfusion (shunt perfusion) in bilateral pulmonary inflammation and indicate redistribution of lung perfusion (antigravitational hyperperfusion) due to cardiac congestion. V/P mismatch and reversed mismatch may be extensive enough to diminish dramatically preserved matching ventilation/perfusion and to induce severe hypoxemia in COVID-19.

Keywords: COVID-19; SARS-CoV-2; SPECT; Ventilation; perfusion; pulmonary embolism.

Publication types

Case Reports