[68Ga]FAPI PET/CT reveals increased pulmonary fibroblast activation protein expression in long COVID patients after ICU discharge.

Purpose: Post-acute sequelae of COVID-19 (PASC) has emerged as a major healthcare problem. A comprehensive mechanism of disease remains to be elucidated. In this study we aimed to explore pulmonary and muscle fibroblast activation protein (FAP) activity in former critical COVID-19 patients with pers...

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Published in:European Journal of Nuclear Medicine & Molecular Imaging Vol. 53; no. 1; pp. 565 - 574
Main Authors: van Leer, B., Londema, M., Kasalak, Ö., van Snick, J. H., Duiverman, M. L., Kuijvenhoven, J. C., de Kruif, M. D., Oprea-Lager, D. E., Pabst, K., Hellemons, M. E., Boersma, H. H., Prokop, M., Nijsten, M. W., Glaudemans, A. W. J. M., Pillay, J., Slart, R. H. J. A., on behalf of the COVID-CLIMATE consortium, Beijers, R. J. H. C. G., van Kuijk, S. M. J., Gach, D.
Format: Journal Article
Published: Springer Nature Dec2025
Online Access:View this record in EBSCOhost
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      dt: Dec2025
      vid: 53
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      pub: Springer Nature
      place: New York, New York
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        186044855
        10.1007/s00259-025-07376-y
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        atl: [68Ga]FAPI PET/CT reveals increased pulmonary fibroblast activation protein expression in long COVID patients after ICU discharge.
      aug:
        au:
          van Leer, B.
          Londema, M.
          Kasalak, Ö.
          van Snick, J. H.
          Duiverman, M. L.
          Kuijvenhoven, J. C.
          de Kruif, M. D.
          Oprea-Lager, D. E.
          Pabst, K.
          Hellemons, M. E.
          Boersma, H. H.
          Prokop, M.
          Nijsten, M. W.
          Glaudemans, A. W. J. M.
          Pillay, J.
          Slart, R. H. J. A.
          on behalf of the COVID-CLIMATE consortium
          Beijers, R. J. H. C. G.
          van Kuijk, S. M. J.
          Gach, D.
        affil: https://ror.org/012p63287 Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
      sug:
      ab: Purpose: Post-acute sequelae of COVID-19 (PASC) has emerged as a major healthcare problem. A comprehensive mechanism of disease remains to be elucidated. In this study we aimed to explore pulmonary and muscle fibroblast activation protein (FAP) activity in former critical COVID-19 patients with persistent dyspnea, using [68Ga]FAPI-46 PET/CT. Methods: In this single center prospective observational study we included former critical COVID-19 patients reporting complaints of dyspnea > 3 months after hospital discharge. A [68Ga]FAPI PET/CT scan was performed including a high-resolution CT scan, lung function test, EQ-5D questionnaire, 6 min walking test and inflammatory markers. Age and sex-matched subjects, without pulmonary pathology, served as controls. The [68Ga]FAPI uptake was corrected for lean body mass and the target-to-background ratio (TBR) was calculated. Results: Eighteen PASC patients and 15 controls (median age 59 and 63 years and BMI of 34.6 and 25.2 kg/m2) were included. The interval between hospital discharge and study visit was 30 months. Increased pulmonary FAP expression was observed in PASC, (TBR 0.79 ± 0.23) compared to controls (TBR 0.40 ± 0.13, P < 0.001). Increased FAP expression was also observed in the paravertebral muscles (PASC: TBR 1.17 and controls TBR 1.00, P = 0.03). Forced expiratory volume and forced vital capacity showed moderate negative correlation with the pulmonary TBR, while the percentage of ground glass opacities showed a moderate positive correlation. Conclusion: [68Ga]FAPI PET/CT demonstrated elevated FAP expression in PASC. These findings provide insight into possible pathophysiological mechanisms of PASC and a potential new diagnostic modality.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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