Multiparameter analysis of vascular remodeling in post-acute sequelae of COVID-19

Mathilde Maury (1, 2, 3) , Aurélien Justet (4) , Juliette Dindart (5) , Jean Richeux (4) , Lucile Sese (5, 6) , Nicolas Aide (4) , Thomas Gille (5) , Hilario Nunes (5) , Jean-François Bernaudin (5, 6) , Pierre-Yves Brillet (5) , Catalin Fetita (1, 3, 2)

1 ARMEDIA-SAMOVAR - ARMEDIA
2 IP Paris - Institut Polytechnique de Paris
3 TSP - ARTEMIS - Département Advanced Research And Techniques For Multidimensional Imaging Systems
4 Service de médecine nucléaire [CHU Caen]
5 Hôpital Avicenne [AP-HP]
6 Université Sorbonne Paris Nord

The COVID-19 infection, a current worldwide health concern, manifests as an alveolar-interstitial pneumonia with unknown long-term evolution. It is also associated with vascular dysfunction and shows a vascular remodeling with a changed balance between small-and large-caliber vessels. In this study, we question the existence of residual vascular alteration in post-acute sequelae of COVID-19 (PASC) by investigating possible associations between vascular remodeling biomarkers extracted from CT and functional, radiological and morphological parameters. The used vascular biomarkers concern the blood volume ratio of vessels with cross-section area inferior to 5 mm 2 versus vessels of crosssection area inferior to 50 mm 2 (BV5/BV50), an index of local peripheral vascular density and a peripheral composite vascular remodeling index, both measured in the antero-postero-lateral lung periphery (excluding mediastinal region). As a functional parameter, diffusing capacity of the lung for carbon monoxide (DLCO) is a measure depending on the vascular perfusion and the amount of interstitial thickening, a decreased DLCO value suggesting altered vascular perfusion. Imaging biomarkers can be extracted from the analysis of perfusion lung scintigraphy or CT scan. Some of them are included in our study. Radiological features include CT attenuation as a measure of persistence of ground glass opacity and development of changes suggestive to look for fibrosis, such as reticulations. As additional morphological parameter, lung deformation observed between inspiration/expiration maneuvers may be suggestive of the presence of reticulations inducing lung stiffness and breathing deficiency. The investigation of associations between vascular remodeling biomarkers obtained from CT and the above functional, radiological and morphological parameters revealed moderate to strong correlations highlighting the ability to capture the persistence of vascular alterations in PASC in relation with the development of fibrotic patterns, which is a promising direction for future research.

Mots clés: Post-acute sequelae of COVID-19 (PASC); Vascular remodeling; Lung deformation; Peripheral vascular density; Peripheral composite remodeling index; Lung perfusion scintigraphy; Computed tomography

Domaines: Traitement du signal et de l'image [eess.SP]

Mathilde Maury, Aurélien Justet, Juliette Dindart, Jean Richeux, Lucile Sese, et al.. Multiparameter analysis of vascular remodeling in post-acute sequelae of COVID-19. MICAD 2022 : Medical Imaging and Computer-Aided Diagnosis, Feb 2022, San Diego, United States. ⟨10.1117/12.2611461⟩. ⟨hal-03791902⟩