Immune-related (IR)-pneumonitis during the COVID-19 pandemic: Multidisciplinary recommendations for diagnosis and management

Jarushka Naidoo, Jarushka Naidoo, Joshua E. Reuss, Joshua E. Reuss, Karthik Suresh, David Feller-Kopman, Patrick M. Forde, Patrick M. Forde, Seema Mehta Steinke, Clare Rock, Douglas B. Johnson, Mizuki Nishino, Julie R. Brahmer, Julie R. Brahmer

Research output: Contribution to journalArticlepeer-review

Abstract

Immune-related (IR)-pneumonitis is a rare and potentially fatal toxicity of anti-PD(L)1 immunotherapy. Expert guidelines for the diagnosis and management of IR-pneumonitis include multidisciplinary input from medical oncology, pulmonary medicine, infectious disease, and radiology specialists. Severe acute respiratory syndrome coronavirus 2 is a recently recognized respiratory virus that is responsible for causing the COVID-19 global pandemic. Symptoms and imaging findings from IR-pneumonitis and COVID-19 pneumonia can be similar, and early COVID-19 viral testing may yield false negative results, complicating the diagnosis and management of both entities. Herein, we present a set of multidisciplinary consensus recommendations for the diagnosis and management of IR-pneumonitis in the setting of COVID-19 including: (1) isolation procedures, (2) recommended imaging and interpretation, (3) adaptations to invasive testing, (4) adaptations to the management of IR-pneumonitis, (5) immunosuppression for steroid-refractory IR-pneumonitis, and (6) management of suspected concurrent IR-pneumonitis and COVID-19 infection. There is an emerging need for the adaptation of expert guidelines for IR-pneumonitis in the setting of the global COVID-19 pandemic. We propose a multidisciplinary consensus on this topic, in this position paper.

Original languageEnglish (US)
Article numbere000984
JournalJournal for immunotherapy of cancer
Volume8
Issue number1
DOIs
StatePublished - Jun 17 2020

Keywords

  • autoimmunity
  • guidelines as topic
  • immunotherapy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Molecular Medicine
  • Oncology
  • Pharmacology
  • Cancer Research

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