COVID-19 pneumonia and immune-related pneumonitis: critical issues on differential diagnosis, potential interactions, and management. (1st September 2020)

• Record Type: Journal Article
• Authors: Russano, Marco; Citarella, Fabrizio; Napolitano, Andrea; Dell'Aquila, Emanuela; Cortellini, Alessio; Pantano, Francesco; Vincenzi, Bruno; Tonini, Giuseppe; Santini, Daniele
• Is Part Of: Expert opinion on biological therapy. Volume 20:Number 9(2020)
• Page Start: 959
• Page End: 964
• Publication Date: 2020-09-01
• Subjects: COVID-19 -- immune checkpoint inhibitors -- pneumonia -- immune-related Pneumonitis -- immunotherapy -- coronavirus; Gene therapy -- Periodicals; Protein drugs -- Periodicals; Peptide drugs -- Periodicals; Immunotherapy -- Periodicals; Drug delivery systems -- Periodicals; 615.5
• DOI: 10.1080/14712598.2020.1789097
• Languages: English
• ISSNs: 1471-2598

Abstract

ABSTRACT: Introduction: The COVID-19 pandemic occurred amid the cancer immunotherapy revolution. Immune checkpoint inhibitors (ICIs) have become the standard of care for several solid cancers and are associated with peculiar toxicities, including pneumonitis which has similar features to COVID-19 pneumonia. Areas covered: We summarize the main hallmarks of lung injury induced by ICIs and severe acute respiratory syndrome coronavirus 2 and discuss the critical aspects for differential diagnosis and management. Symptoms and radiological findings are often similar; conversely, treatments are quite different. Furthermore, we focus on potential interactions generating hypotheses that need confirmatory studies. Expert opinion: All cancer patients treated with immunotherapy should receive screening for SARS-CoV-2. This would improve the diagnosis and management of pneumonia and guide therapeutic choices. Furthermore, clinicians could estimate the risk/benefit of continuing ICI treatment in COVID-19 positive patients. Temporary withdrawal of the immunotherapy treatment pending resolution of viral infection may be a reasonable option in long-responders patients.