LAUSR

A 48-year-old woman presented with 10-day history of cough and fever (up to 39.1 °C). Nasopharyngeal swab specimen was positive for COVID-19 nucleic acid test (RT-PCR). Detailed time course of the clinical data, laboratory tests, and imaging findings of computed tomography (CT) and [F] fluorodeoxyglucose ([F] FDG) positron emission tomography (PET/CT) are described in the figure. Chest CT obtained from day 7 to day 15 of the hospitalization showed GGOs (ground glass opacities) with crazypaving pattern to consolidative opacities. Following antiviral (hydroxychloroquine hydrochloride and interferon) and antiinflammatory (budesonide and albumin) treatment for several days, the patient was effectively relieved from clinical symptoms and was negative in two subsequent RT-PCR tests (day 13, day 14). [F] FDG PET/CT scan (day 16) was performed to evaluate any other active disease process. It showed multiple FDG-positive consolidative opacities in both lungs (PET, fusion; SUVmax ranged 2.7–5.9) and multiple FDG-avid lymph nodes in the left subclavian, mediastinum, and hilum regions (arrows, fusion; SUVmax ranged 2.9–6.5) A follow-up chest CT acquired 2-month post-discharge (day 77) revealed few GGOs. RT-PCR was again negative. FDG-positive consolidative opacities in both lungs imply persistent inflammatory burden, while the patient was recovering and negative in RT-PCR. FDG-avid lymph nodes also suggest lingering lymphadenitis [1, 2]. FDG uptake may vary with different stages of virus and disease [3]. FDG PET/CT with its capability of directly mapping the location and activity of inflammation during virus exposure may have a role to play when there is uncertainty of diagnosis, for clinical management and for monitoring the effect of treatment [4].