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 Table of Contents  
SHORT COMMUNICATION
Year : 2022  |  Volume : 7  |  Issue : 2  |  Page : 325-326

Management strategies for tackling COVID-19 pneumonia in patients with lung cancer: Experience gained during the pandemic


Department of Radiology, St. John's Hospital, Bengaluru, Karnataka, India

Date of Submission12-Jan-2022
Date of Decision02-Feb-2022
Date of Acceptance03-Feb-2022
Date of Web Publication09-Sep-2022

Correspondence Address:
Ravikanth Reddy
Department of Radiology, St. John's Hospital, Bengaluru - 560 034, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bjhs.bjhs_7_22

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  Abstract 


Chest imaging during the COVID-19 pandemic should ideally be reserved for patients with moderate-severe disease or in mild cases with worsening respiratory status. Lung cancer patients who contract COVID-19 have greater risk for severity, disease progression, early deterioration and high mortality as compared to the general population. Radiologists who are at the forefront of imaging technology have to take responsibility of notifying the managing physicians of the initial findings in lung cancer patients with suspected COVID-19 in order to implement precautionary measures. Optimal management strategies with intense surveillance measures have to be adopted in such patients during the pandemic to reduce disease burden and to achieve better prognostic outcomes related to lung cancer treatment

Keywords: COVID-19 pneumonia, lung cancer, pandemic


How to cite this article:
Reddy R. Management strategies for tackling COVID-19 pneumonia in patients with lung cancer: Experience gained during the pandemic. BLDE Univ J Health Sci 2022;7:325-6

How to cite this URL:
Reddy R. Management strategies for tackling COVID-19 pneumonia in patients with lung cancer: Experience gained during the pandemic. BLDE Univ J Health Sci [serial online] 2022 [cited 2023 Jan 28];7:325-6. Available from: https://www.bldeujournalhs.in/text.asp?2022/7/2/325/355857




  Case Description Top


A novel strain of coronavirus was found in bronchoalveolar lavage samples of patients with a lower respiratory tract infection, first traced from the city of Wuhan, Hubei Province of the People's Republic of China in December 2019.[1] With the dramatic widespread increase of COVID-19 cases, management of patients with lung cancer has become a challenge due to the prioritization of health-care resources for the management of patients affected during the COVID-19 outbreak. Patients with lung cancer are highly vulnerable to being infected with coronavirus due to immunosuppression and should be protected by vaccination with priority. A 62-year-old male patient of Indian ethnicity presented with complaints of 3-day history of dry cough, fever, headache, and generalized fatigue. He had a recent travel history to Italy was diagnosed with Stage III bronchogenic carcinoma and lymphangitis carcinomatosis 5 months before his presentation and was advised admission in the critical care unit of the hospital. Nasopharyngeal and oropharyngeal swab and sputum samples of the patient were collected to detect COVID-19 by reverse transcriptase-polymerase chain reaction (RT-PCR). RT-PCR confirmed positivity on day 4 of admission and follow-up computed tomography revealed patchy consolidation in bilateral basal lung segments [Figure 1]. The patient succumbed to the disease on day 7 of admission and chest X-ray done few hours earlier to his demise demonstrated extensive consolidation with bilateral lower zones [Figure 2].
Figure 1: Computed tomography image on day 4 of admission demonstrating subpleural distribution of reticular pattern opacities suggesting fibrosis in basal segments of bilateral lower lobes

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Figure 2: Supine radiograph in anteroposterior projection on day 7 of admission demonstrating extensive consolidation in bilateral, peripheral and basal distribution

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  Management Strategies Top


Screening for lung cancer in patients should be halted for a while till the peak of the pandemic curve flattens as to prevent exposure to coronavirus infection and haywire progression of morbidity-related complications. Furthermore, elaborative workup of incidental findings in these patients may lead to performing unwanted procedures during the pandemic adding to the burden by depleting the already available limited medical resources. Tailored management plans regarding the choice of chemotherapy and targeted treatment for cancer patients should be based on demographic characteristics and preexisting comorbidities. All elective surgeries scheduled in cancer patients above 65 years of age should be postponed considering the added risks of infection and higher mortality rates.[2] Furthermore, surgery should be deferred in lung cancer patients with low left ventricular ejection fraction, prosthetic heart valves, uncontrolled diabetes, chronic obstructive pulmonary disease, chronic liver disease, and chronic kidney disease.[3] Majority of oncologists have adopted new treatment plans for patients with lung cancer to ensure better quality care within the available resources while still adhering to the new protocols and guidelines recommended by the Centers for Disease Control and Prevention. In combination with determining a treatment plan for lung cancer, health-care providers and stakeholders should educate cancer patients and their caretakers regarding preventive measures that need to be adopted according to World Health Organization guidelines for furthering the spread of coronavirus pneumonia. Nevertheless, patients who consider undertaking treatment during the pandemic should strictly adhere to self-isolation practices for the benefit of themselves, other critically ill patients, and health-care personnel. In conclusion, preventive measures to tackle COVID-19 pneumonia, providing timely medical treatment, early recognition of treatment-related complications, and providing emotional support are strategies that need to be implemented for mitigation of consequences of the pandemic in lung cancer patients.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient's parents have given their consent to their child's images and other clinical information to be reported in the journal. The parents understand that their child's name and initials will not be published and due efforts will be made to conceal the identity, but anonymity cannot be guaranteed.

Acknowledgments

The author would like to thank Mrs. Mani Sabbavarapu for her assistance in proofreading and native English editing of the manuscript.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-33.  Back to cited text no. 1
    
2.
Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K, Marelli-Berg FM, et al. COVID-19 and the cardiovascular system: Implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res 2020;116:1666-87.  Back to cited text no. 2
    
3.
Shah SB, Chawla R. Cancer in corona times. Saudi J Anaesth 2020;14:504-9.  Back to cited text no. 3
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