2026/06/01 by Ravindra Ganesh, Kaavya Nair, Stephanie L. Grach +4 · 1 voice
Medicine · #Cerebral cortex #Coronavirus disease 2019 (COVID-19) #Disease #Fibromyalgia and Chronic Fatigue Syndrome Research #Intensive Care Unit Cognitive Disorders #Long-Term Effects of COVID-19 #Malaise #Neuroimaging #Pathophysiology #Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) #White matter
paper · doi:10.1177/21501319261458748
published in Journal of Primary Care & Community Health 17, 21501319261458748 (SAGE Publishing)
openalex publication_date 2026/06/01 · openalex created_date 2026/06/09 · openalex updated_date 2026/07/30
Objective Long COVID (LC) refers to the long-term symptoms occurring after SARS-CoV-2 infection and resolution of the initial disease prodrome. While LC is increasingly recognized, knowledge about its biomarkers is still limited. This study examines imaging findings in 18 F-FDG PET-CT scans in 40 patients with LC from an academic LC Clinic, for potential imaging biomarkers. Methods This study included patients aged 18 and older with confirmed positive SARS-CoV-2 PCR test and at least 28 days post-symptom onset. 18 F-FDG PET-CT scans were performed, and brain metabolic activity was compared to a control database to generate Z-scores. Participants were grouped based on their clinical phenotype and Z-scores of different brain regions were analyzed using t-tests. Results The study group was mainly female (70%), with a median age of 53 years, and predominantly non-Hispanic White (90%). Most had pre-existing conditions such as gastrointestinal, cardiovascular, endocrine, and psychiatric disorders. The findings showed significant cerebral hypometabolism in 29 patients with fatigue and post-exertional malaise (PEM), particularly in the left sensorimotor cortex (p=0.0253) and bilateral primary visual cortex (right: p=0.0096, left: p=0.0016), which persisted up to two years after infection. Conclusions In summary, this study identified persistent cerebral hypometabolism in LC patients, especially those with fatigue with PEM, up to two years post-infection. These results suggest that 18 F-FDG PET-CT could be a valuable tool for diagnosing and managing LC. Further research is essential to confirm these findings and improve treatment strategies for patients with LC.