This study uses total-body \[¹⁸F\]F-AraG PET/CT imaging to investigate immune activation and vascular changes in individuals with post-acute sequelae of SARS-CoV-2 infection (PASC), also known as Long COVID. Participants will undergo dynamic PET/CT imaging along with blood biomarker assessments and symptom evaluations. The study aims to characterize sites of immunological perturbation, correlate PET imaging findings with peripheral blood markers, and evaluate longitudinal changes in tissue-based immune activity in relation to symptom patterns over time. Data from this study will improve understanding of tissue-level immune dysregulation in PASC and support future clinical tools for assessing and managing this condition.
Post-acute sequelae of SARS-CoV-2 infection (PASC) is associated with persistent immune dysregulation affecting multiple organ systems. This prospective, non-randomized, open-label research study will apply high-sensitivity total-body PET/CT imaging using the investigational radiotracer \[¹⁸F\]F-AraG to map immune activation across diverse tissues in PASC and COVID-19-recovered control participants. The tracer, \[¹⁸F\]F-AraG, selectively accumulates in activated T cells and allows kinetic modeling of immune cell activity in vivo. A total of 51 participants will be enrolled, including 34 PASC participants and 17 controls. All participants will undergo baseline imaging, and a subset of 17 PASC participants will complete two additional follow-up scans at 4 and 8 months. Each imaging visit includes a dynamic PET/CT scan, peripheral blood draws for plasma proteomics and immunophenotyping, and symptom questionnaires collected through the UCSF LIINC cohort. Findings will be used to identify tissue-specific immune signatures associated with symptom phenotypes and assess how these evolve over time. The results will help clarify the biological basis of PASC and support the development of future diagnostic or monitoring strategies. No direct health benefit is anticipated for participants.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
51
Participants receive an intravenous injection of 5 mCi (±20%) of \[¹⁸F\]F-AraG followed by a 90-minute total-body PET/CT scan and an additional 30-minute static scan at 4 hours post-injection. Blood samples (up to 42 mL total) are collected during dynamic imaging.
Participants receive an intravenous injection of 5 mCi (±20%) of \[¹⁸F\]F-AraG followed by a 60-minute total-body PET/CT scan. Blood samples (up to 42 mL total) are collected during dynamic imaging.
Participants receive an intravenous injection of 5 mCi (±20%) of \[¹⁸F\]F-AraG followed by a 90-minute total-body PET/CT scan and a second 30-minute scan at 4 hours. Blood samples (up to 42 mL total) are collected during dynamic imaging.
Participants receive 5 mCi (±20%) of \[¹⁸F\]F-AraG intravenously followed by a 60-minute total-body PET/CT scan. Blood samples (up to 42 mL total) are collected during dynamic imaging.
UC Davis EXPLORER Molecular Imaging Center
Sacramento, California, United States
RECRUITINGUniversity of California San Francisco
San Francisco, California, United States
RECRUITINGQuantification of [¹⁸F]F-AraG uptake kinetics in PASC and control participants
To assess immune activation in convalescent COVID-19, dynamic PET/CT scans will be analyzed to generate time-activity curves (TACs) in multiple tissues. Kinetic modeling will be applied to extract uptake parameters including SUV, SUVR, Vt, Ki, and k3. These values will be reported and statistically compared between PASC and control participants.
Time frame: Baseline Imaging Visit
Correlation between [¹⁸F]F-AraG uptake parameters and blood-based markers of immune dysregulation
Spearman correlation tests and heat map clustering will be used to assess the association between PET-derived uptake measures and plasma biomarkers of inflammation and immune activation. Correlations will be examined in tissues showing significant uptake differences between study groups.
Time frame: Baseline imaging visit and baseline blood draw
Longitudinal change in [¹⁸F]F-AraG uptake and correlation with PASC symptom scores
In a subset of participants, follow-up PET/CT imaging at 4 and 8 months will be used to assess within-subject change in kinetic uptake parameters. These changes will be compared to changes in symptom burden as measured by PHQ-15 symptom domain scores.
Time frame: Baseline, 4-month, and 8-month follow-up visits (subset of PASC participants only)
Feasibility of blood flow kinetic modeling using early [¹⁸F]F-AraG dynamic PET data
Early-phase TACs (\< 5 min post-injection) will be fitted using the AATH model to estimate blood flow from the vascular phase of radiotracer distribution. Identifiability of kinetic parameters associated with vascular function will be evaluated. Mean values will be compared between study groups.
Time frame: Baseline imaging visit
Correlation between vascular imaging parameters and blood biomarkers of vascular dysfunction
Spearman correlations and heatmap analyses will be used to examine associations between PET-derived vascular parameters and plasma markers of vascular dysfunction.
Time frame: Baseline imaging visit and baseline blood draw
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