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

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...

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Autores principales: Naidoo, Jarushka, Reuss, Joshua E, Suresh, Karthik, Feller-Kopman, David, Forde, Patrick M, Mehta Steinke, Seema, Rock, Clare, Johnson, Douglas B, Nishino, Mizuki, Brahmer, Julie R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316105/
https://www.ncbi.nlm.nih.gov/pubmed/32554619
http://dx.doi.org/10.1136/jitc-2020-000984
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author Naidoo, Jarushka
Reuss, Joshua E
Suresh, Karthik
Feller-Kopman, David
Forde, Patrick M
Mehta Steinke, Seema
Rock, Clare
Johnson, Douglas B
Nishino, Mizuki
Brahmer, Julie R
author_facet Naidoo, Jarushka
Reuss, Joshua E
Suresh, Karthik
Feller-Kopman, David
Forde, Patrick M
Mehta Steinke, Seema
Rock, Clare
Johnson, Douglas B
Nishino, Mizuki
Brahmer, Julie R
author_sort Naidoo, Jarushka
collection PubMed
description 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.
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spelling pubmed-73161052020-06-26 Immune-related (IR)-pneumonitis during the COVID-19 pandemic: multidisciplinary recommendations for diagnosis and management Naidoo, Jarushka Reuss, Joshua E Suresh, Karthik Feller-Kopman, David Forde, Patrick M Mehta Steinke, Seema Rock, Clare Johnson, Douglas B Nishino, Mizuki Brahmer, Julie R J Immunother Cancer Position Article and Guidelines 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. BMJ Publishing Group 2020-06-16 /pmc/articles/PMC7316105/ /pubmed/32554619 http://dx.doi.org/10.1136/jitc-2020-000984 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Position Article and Guidelines
Naidoo, Jarushka
Reuss, Joshua E
Suresh, Karthik
Feller-Kopman, David
Forde, Patrick M
Mehta Steinke, Seema
Rock, Clare
Johnson, Douglas B
Nishino, Mizuki
Brahmer, Julie R
Immune-related (IR)-pneumonitis during the COVID-19 pandemic: multidisciplinary recommendations for diagnosis and management
title Immune-related (IR)-pneumonitis during the COVID-19 pandemic: multidisciplinary recommendations for diagnosis and management
title_full Immune-related (IR)-pneumonitis during the COVID-19 pandemic: multidisciplinary recommendations for diagnosis and management
title_fullStr Immune-related (IR)-pneumonitis during the COVID-19 pandemic: multidisciplinary recommendations for diagnosis and management
title_full_unstemmed Immune-related (IR)-pneumonitis during the COVID-19 pandemic: multidisciplinary recommendations for diagnosis and management
title_short Immune-related (IR)-pneumonitis during the COVID-19 pandemic: multidisciplinary recommendations for diagnosis and management
title_sort immune-related (ir)-pneumonitis during the covid-19 pandemic: multidisciplinary recommendations for diagnosis and management
topic Position Article and Guidelines
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316105/
https://www.ncbi.nlm.nih.gov/pubmed/32554619
http://dx.doi.org/10.1136/jitc-2020-000984
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