The purpose of this study is to evaluate pulmonary function of patients recovering frommild, moderate, and severe COVID-19 disease using hyperpolarized 129Xe MRI.
COVID-19, the disease at the heart of the current global pandemic, is characterized by
fevers, cough, sore throat, malaise, and myalgias, with 98% of patients experiencing some
pulmonary involvement. In those infected with the causative virus, SARS-CoV-2, the
severity of symptoms, as well as their duration, is widely variable. There is strong
evidence from computed tomography (CT) images of patients with severe COVID-19 that
pulmonary abnormalities and lung damage caused by infection may have long-term
consequences for survivors. Furthermore, many patients with mild or moderate experience
symptoms such as fatigue and dyspnea long (>60 days) after initial symptom onset, but
there are currently no clinical predictors of which patients are at greatest risk for
long-term health effects. As such, sensitive and specific predictors or biomarkers that
can evaluate quality-of-life, risk of infection exacerbation, and long-term outcomes are
critically needed.
Pulmonary imaging using hyperpolarized (HP) 129Xe magnetic resonance imaging (MRI)
provides a means to detect abnormalities in the pulmonary small airways, vasculature, and
parenchyma by quantifying pulmonary ventilation, gas diffusion, and regional gas
exchange. HP 129Xe MRI is fast (<16s), non-invasive, and radiation free, making it a safe
and effective method for characterizing lung function, even in individuals with lung
disease. In this pilot study, we will use HP 129Xe to evaluate pulmonary structure and
function in COVID-19 patients using the following specific aims:
Aim 1. Detect regional pulmonary function abnormalities in recovering COVID-19 patients
using hyperpolarized 129Xe MRI. The hypothesis is that ventilation and gas exchange
defects will be present in recovering COVID-19 patients, and further that the extent of
impairment will correlate with disease severity.
Aim 2. Determine risk factors for long term outcomes using hyperpolarized 129Xe MRI and
clinical biomarkers. The hypothesis is that HP 129Xe MRI biomarkers will predict
long-term lung function impairment brought on by COVID-19.
These aims will be tested by performing HP 129Xe MRI in patients recovering from mild,
moderate, or severe COVID-19. By coming to a fuller understanding of the long-term
impairment of pulmonary function, future treatment can be optimized to minimize severe
disease and health care utilization.
Drug: Hyperpolarized Xe129
Subjects will inhale up to 4 doses of hyperpolarized Xenon gas in order to image
pulmonary function.
Other Name: HP Xenon,129Xe
Inclusion Criteria:
- Oxygenation saturation of ≥88% at rest by study staff within 48 hours prior to study
entry.
- The participant has a previous diagnosis of COVID-19 confirmed by COVID-19 PCR or
antibody testing and is being seen for outpatient follow-up.
- Subject is at least 10 days post-symptom-onset and do not have a fever (<99.5°).
- Ability to read and understand English or Spanish
Exclusion Criteria:
- Subject is less than 18 years old
- MRI is contraindicated based on responses to MRI screening questionnaire
- Subject is pregnant or lactating
- Subject does not fit into 129Xe vest coil used for MRI
- Subject cannot hold his/her breath for 15-16 seconds
- Subject deemed unlikely to be able to comply with instructions during imaging
- Oxygen saturation <88% on room air or with supplemental oxygen
- Cognitive deficits that preclude ability to provide consent
- Institutionalization
University of Kansas Medical Center
Kansas City, Kansas, United States