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07-07-2020 | COVID-19 | News


Guidelines for managing immune-related pneumonitis during COVID-19 published

Shreeya Nanda

medwireNews: A multidisciplinary panel has issued recommendations for the diagnosis and management of immune-related pneumonitis in cancer patients during the COVID-19 outbreak.

“Immune-related (IR)-pneumonitis is a rare and potentially fatal toxicity of anti-PD(L)1 immunotherapy” that presents with similar symptoms to COVID-19, including “fever, cough, myalgia, fatigue, and shortness of breath,” explain the guideline authors in the Journal for ImmunoTherapy of Cancer.

They continue: “[T]he ability to effectively discern and appropriately manage IR-pneumonitis in the context of COVID-19 is a question of increasing clinical relevance in patients with cancer, since anti-PD(L)1 immunotherapy is approved in 15 different cancer indications, with over 40% of patients with cancer in the USA now being eligible to receive immunotherapy in a standard of care setting.”

The multidisciplinary group, led by Jarushka Naidoo (Johns Hopkins University, Baltimore, Maryland, USA), therefore adapted existing IR-pneumonitis guidelines in the context of COVID-19, addressing the following issues:

isolation procedures;imaging and interpretation;adaptations to invasive testing for IR-pneumonitis;adaptations to current medical management of IR-pneumonitis;immunosuppressive therapy for steroid-refractory IR-pneumonitis; andmanagement of suspected concurrent IR-pneumonitis and COVID-19 infection.

Naidoo and colleagues caution that these recommendations “represent expert opinion that is based on limited and primarily retrospective data” and “are subject to change as new data become available.”

The consensus guidelines were drafted using modified Delphi methodology, with input from medical oncologists, radiologists, and infectious diseases and pulmonary medicine specialists with expertise in IR-pneumonitis and COVID-19.

medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group

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J Immunother Cancer 2020; 8: e000984