Severe Post-COVID-19 Organizing Pneumonia during Cancer Immunochemotherapy

• Published in: Internal Medicine Vol. 61; no. 8; pp. 1219 - 1223
• Main Authors: Kitahara, Asako, Ebihara, Akinori, Obayashi, Shohei, Horio, Yukihiro, Ono, Yoshitaka, Yoshikawa, Tomohiro, Okada, Naoki, Tanaka, Jun, Takiguchi, Hiroto, Hayama, Naoki, Ito, Yoko, Oguma, Tsuyoshi, Kuwahira, Ichiro, Asano, Koichiro
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.04.2022; Japan Science and Technology Agency
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Cancer; Carboplatin; Carcinoma, Non-Small-Cell Lung - drug therapy; Case Report; Colony-stimulating factor; Coronaviruses; COVID-19; febrile neutropenia; Fever; Granulocyte colony-stimulating factor; Granulocyte Colony-Stimulating Factor - therapeutic use; Humans; Hydrocortisone; Hypotension; Hypoxemia; Hypoxia - drug therapy; Immune checkpoint inhibitors; immune-checkpoint inhibitor; Internal medicine; Leukocytes (granulocytic); Lung Neoplasms - complications; Lung Neoplasms - drug therapy; Male; Metastases; Neutropenia; Non-small cell lung carcinoma; Paclitaxel; Pembrolizumab; Pneumonia; severe acute respiratory syndrome coronavirus 2; Small cell lung carcinoma; tumor regression; Tumors; tumor regression; febrile neutropenia; granulocyte colony-stimulating factor; severe acute respiratory syndrome coronavirus 2; immune-checkpoint inhibitor
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.8928-21

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.