Better predict disease course
‘This contributes to more targeted and faster treatment of sick patients and to better predicting the course of disease, recovery and complaints in the long term. ZonMw has provided a subsidy of almost 800,000 euros for this research.
Collaboration Dutch academic hospitals
Scientists from all Dutch academic hospitals, the VieCuri Medical Center and the Zuyderland Medical Center are working together in this research, coordinated by Maastricht UMC+.
Therapy
In the early days of the pandemic, COVID patients were treated with only supportive therapy such as oxygen or ventilation. Later, anti-inflammatories and drugs that suppress the immune system were found to have a positive effect, but some of these drugs are expensive or have unpleasant side effects. They are only given to very seriously ill patients, who, however, do not all respond well to them. It is therefore important to accurately estimate which patients will benefit from this medication, so that admissions to intensive care can be avoided.
Mapping patient groups
The researchers are now trying to map this out by relating information from the CT scans of approximately 1000 COVID-19 patients to disease course, laboratory values, length of stay, treatment type and complications. For this purpose, information about patients from previous waves is mainly used, but it is also investigated whether the results are applicable to patients in the current wave, who will often be infected with the omikron variant. In this way, the researchers hope to provide insight into how early choices can be made for targeted treatment on the basis of a CT scan.
CT-scanner
A CT scanner is an X-ray machine in which an X-ray tube revolves around the patient and thus ‘photographs’ the patient. Cross-sections or ‘slices’ of the body part being scanned are calculated from this information. These slices together form a CT scan. Doctors use these scans for diagnosis and evaluation of disease course and for optimization of treatment. A CT scan of the lungs can show abnormalities typical of COVID-19 and provide information about the severity of these abnormalities.
To predict
The CT scan also provides information about muscle mass, muscle quality and mass and distribution of adipose tissue. This additional information is relevant to the patient’s overall condition, disease course and perceived disease burden. That is why – in addition to the scan data on admission – the scans are also analyzed after three months and one year after diagnosis. In this way, the scientists hope to determine what the results of a CT scan upon admission and changes in the recovery phase mean for the later course of the disease and any complaints in the longer term.
Long-term complaints
About 10 to 20% of COVID-19 patients have long-term complaints that seriously hinder daily life. A tailor-made approach to these complaints is therefore necessary. The results of the CT scans are therefore compared after at least 1 year with an extensive health check consisting of measurements of lung function, muscle function, exercise capacity and the cardiovascular risk profile so that complaints such as shortness of breath, fatigue and a reduced quality of life can be better understood.
New kind of scan
An experimental part is also included in this project. For some patients, the researchers will make a new type of scan, the so-called FAPI PET/CT scan. This scan can determine whether abnormalities seen several months after recovery are caused by persistent inflammation or by early scarring in the lungs. This offers new insights for the treatment of residual complaints and abnormalities a few months after discharge.
Planning
The investigation started on September 1, 2021 and will run for two years. The first research results are expected in the course of 2022.
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