Pulmonary changes during COVID-19 pandemic on routine imaging in radiotherapy

Morten Hiul Suppli | maj 2020 | COVID-19 |

Morten Hiul Suppli
Doctor, PhD,
Department of Oncology,
Copenhagen University Hospital

The ongoing pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected oncology departments across the globe with different means of precautions to protect cancer patients from COVID-19. In Copenhagen, Denmark we reported a case of a patient with pulmonary adenocarcinoma undergoing concomitant chemoradiotherapy with a platinum doublet regime and radiation of 60 Gray in 30 fractions.1 The patient was admitted to the hospital during the second week of radiotherapy with fever, cough and malaise. He tested positive for SARS-CoV-2 and died shortly from respiratory failure. One respective review of daily setup imaging during treatment, appearance of ground glass opacities within the lungs could be identified prior to reported patient symptoms. Afterwards similar cases have been reported in the United States and Italy.2,3 Staff in radiotherapy departments should prioritize to review daily thoracic imaging to identify the appearance of new pulmonary infiltrates. This can lead to prompt testing for COVID-19 and ensure protection of both patients and personnel. Data are currently lacking on whether to continue or withhold treatment in COVID+ patients with lung cancer and decisions should be made on an individual basis.4 Data sharing and reporting of COVID+ patients with cancer should be encouraged to guide treatment during the ongoing pandemic.