Severe Post-COVID-19 Organizing Pneumonia during Cancer Immunochemotherapy

Intern Med. 2022 Apr 15;61(8):1219-1223. doi: 10.2169/internalmedicine.8928-21. Epub 2022 Feb 8.

Abstract

A 44-year-old man developed coronavirus disease 2019 (COVID-19) pneumonia during immunochemotherapy consisting of carboplatin, paclitaxel, and pembrolizumab for non-small cell lung cancer. Low-grade fever, followed by mild hypoxemia, and febrile neutropenia, were observed, and granulocyte colony-stimulating factor (G-CSF) was administered until the recovery of neutropenia, when he developed a high fever, severe hypoxemia, and hypotension accompanied by consolidation in the bilateral lungs. His conditions promptly improved after treatment including hydrocortisone and the primary and metastatic tumors remained regressed for 10 months without further treatment. Post-COVID-19 organizing pneumonia during cancer immunochemotherapy can be aggravated by immune-checkpoint inhibitors and G-CSF.

Keywords: febrile neutropenia; granulocyte colony-stimulating factor; immune-checkpoint inhibitor; severe acute respiratory syndrome coronavirus 2; tumor regression.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • COVID-19*
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Humans
  • Hypoxia / drug therapy
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / drug therapy
  • Male

Substances

  • Granulocyte Colony-Stimulating Factor