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In a new study into the longer-term damage amongst patients recovering from COVID-19, DPAG Research Fellow Dr James Grist of the Tyler Lab has been running a novel scanning technique that shows a dramatic decrease in the ability of the lungs to diffuse gas in to the blood stream after COVID infection. This work may shed light on the problem of breathlessness after COVID infection and help guide us in understanding therapeutic selection and efficacy.

Scarred lungs compared with healthy lungs show much larger areas of darkness, representing parts of the lungs that are having difficulty transporting oxygen into the blood stream. © University of Oxford

 

Our lightbulb moment was when we first reconstructed the data from post-COVID patients and saw the extent of the damage that can be caused by the disease, in otherwise healthy-looking lungs.
- Dr James Grist

Many patients of COVID-19 continue to remain short of breath following treatment, even after discharge. A new study from collaborative teams in Oxford and Sheffield Universities is the first in Europe to use hyperpolarised xenon gas with MRI scanning to identify previously unseen damage to lung function as patients recover from COVID-19 that are not picked up by conventional scans.

Hyperpolarised xenon MRI is unique in its ability to measure gas transfer in the lungs with imaging and identify where the damage caused by COVID-19 pneumonia has occurred. The technique uses lasers to temporarily increase the signal available from Xenon and thus enable imaging in the MRI scanner.

Early data analysed by DPAG’s Dr James Grist, who has been running the scans of COVID-19 patients at the Churchill Hospital, shows weakened lung function in all study participants, whereas strikingly this damage to lungs is not visible on a standard MRI or CT scan. According to Dr Grist: “The conventional imaging (CT) of these patients was clear, and described as ‘healthy’, but our technique showed up some serious problems in gas transport.” 

The data suggests that the ability to transfer oxygen from the lungs into the blood stream when breathing is visibly impaired for some time, even after hospital discharge following COVID-19 pneumonia. This ultimately may be an explanation for some patients experiencing persistent symptoms even if standard GP and hospital tests return normal results.

The research team, led by Professor Fergus Gleeson from Oxford’s Department of Oncology and Professor Jim Wild from the University of Sheffield Medical School, have been working initially with a group of 40 patients from Oxford and Sheffield over the next six months. The striking early results have prompted discussions to expand the study to involve more patients in the community and thus identify the overall prevalence of lung damage.

Dr James Grist said: “We are really interested to see if this damage persists over time, or if it is just a transient effect. We’ll use this technology to help understand the prevalence of gas transport deficits in many more patients post-COVID.”

 

The study is funded by the NCIMI and the University of Oxford, and supported by the NIHR Oxford Biomedical Research Centre. It will be linked to the big national clinical follow-up study PHOSP-COVID.

Those interested in this study can contact ncimi@oncology.ox.ac.uk.

 

These early results have been covered by the BBC.

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