Postacute COVID-19 Syndrome: ¹²⁹Xe MRI Ventilation Defects and Respiratory Outcomes 1 Year Later.

Abstract

Background In individuals with postacute COVID-19 syndrome (PACS) and normal pulmonary function, xenon 129 (¹²⁹Xe) MRI ventilation defects, abnormal quality-of-life scores, and exercise limitation were reported 3 months after infection; the longitudinal trajectory remains unclear. Purpose To measure and compare pulmonary function, exercise capacity, quality of life, and ¹²⁹Xe MRI ventilation defect percent (VDP) in individuals with PACS evaluated 3 and 15 months after COVID-19 infection. Materials and Methods In this prospective study, participants with PACS aged 18-80 years were enrolled between July 2020 and August 2021 from two quaternary care centers. ¹²⁹Xe MRI VDP, diffusing capacity of lung for carbon monoxide (Dlco), spirometry, oscillometry, 6-minute walk distance (6MWD), and St George Respiratory Questionnaire (SGRQ) scores were evaluated 3 months and 15 months after COVID-19 infection. Differences between time points were evaluated using the paired <i>t</i> test. Multivariable models were generated to explain exercise capacity and quality-of-life improvement. Odds ratios (ORs) were used to evaluate potential treatment influences. Results Overall, 53 participants (mean age, 55 years ± 18 [SD]; 27 women) attended both 3- and 15-month visits and were included in the analysis. The mean values for ¹²⁹Xe MRI VDP (5.8% and 4.2%; <i>P</i> = .003), forced expiratory volume in the 1st second of expiration percent predicted (84% and 90%; <i>P</i> = .001), Dlco percent predicted (86% and 99%; <i>P</i> = .002), and SGRQ score (35 and 25; <i>P</i> < .001) improved between the 3- and 15-month visit. VDP measured 3 months after COVID-19 infection predicted the change in 6MWD (β = -0.643, <i>P</i> = .006), while treatment with respiratory medication at 3 months predicted an improved quality-of-life score at 15 months (OR, 4.0; 95% CI: 1.2, 13.8; <i>P</i> = .03). Conclusion Pulmonary function, gas exchange, exercise capacity, quality of life, and ¹²⁹Xe MRI ventilation defect percent (VDP) improved in participants with postacute COVID-19 syndrome at 15 months compared with 3 months after infection. VDP measured at 3 months after infection correlated with improved exercise capacity, while treatment with respiratory medication was associated with an improved quality-of-life score 15 months after infection. ClinicalTrials.gov registration no. NCT05014516 © RSNA, 2023 <i>Supplemental material is available for this article.</i> See also the editorial by Vogel-Claussen in this issue.