As supposed, nasopharyngeal swab was positive for SARS-Cov-2 infection. taking vandetanib for metastatic medullary thyroid cancer (MTC), when he came to our attention referring severe fatigue, dyspnea for light physical activities. He presented a mild COVID-19 and he received exclusively supportive care. After a multidisciplinary consultation, we decided against the discontinuation of vandetanib. After 2 months from the infection, he did not present any signs of active infection, and the MTC metastatic disease was stable. Conclusions We showed that COVID-19 is not more frequent in TC patients than in general population, although a relatively higher prevalence in the group of TC patients treated with MKIs. A single patient with advanced TC and SARS-Cov-2 infection during MKIs treatment had a mild COVID-19 and did not require the discontinuation of MKI therapy. In cases of more severe COVID-19, an accurate evaluation from a multidisciplinary team would consider risks and benefits in taking the decision to continue or stop MKI treatment. interquartile range, medullary thyroid cancer, papillary thyroid cancer, follicular thyroid cancer, poorly differentiated thyroid cancer, (+)-JQ1 chronic obstructive pulmonary disease, Multikinase inhibitors Most of the Rabbit Polyclonal to Gab2 (phospho-Tyr452) patients were taking lenvatinib (40.3%) or vandetanib (34.7%), while only a few patients were taking cabozantinib (5.6%), selpercatinib (11.1%), or sunitinib (1.4%). At October 2020, the median (+)-JQ1 duration of MKIs treatment was 32 months. The COVID-19 patient taking MKIs On May 7, 2020, after 18 months of vandetanib treatment (200?mg/day), a 64-year-old man affected by an MTC with multiple metastases in cervical and mediastinal lymph nodes, lungs, liver, and bone came to our attention reporting severe fatigue, dyspnea for light physical activities, and a remarkable loss of weight (?6?Kg in 2 months). Otherwise, he denied fever, cough, and further symptoms. At physical examination, he presented only tachypnea. He also reported that, 2 months before, his mother had got SARS-Cov-2 infection and she passed away, after 1 month of hospitalization. Based on his clinical presentation and history, after excluding a worsening of the neoplastic disease, suspecting COVID-19 he was sent to the emergency department. On arrival, he presented respiratory alkalosis (pH 7.51, pCO2 26?mmHg, pO2 104?mmHg, and HCO3? 20.7?mmol/L) and optimal O2 saturation (96.9%). As supposed, nasopharyngeal swab was positive for SARS-Cov-2 infection. Computer tomography (CT) scan documented the appearance of interstitial thickening of the right lung, in addition to the well-known multiple (+)-JQ1 lung metastasis (Fig. ?(Fig.1).1). Because the COVID-19 (+)-JQ1 was not severe and the lung involvement was mild, after a multidisciplinary meeting, it was decided to avoid any antiviral or immunomodulatory treatment for COVID-19, but only supportive treatment so that he could continue vandetanib treatment. After a significant improvement of his medical conditions and two negative nasopharyngeal swabs, he was discharged. Two months after the diagnosis, he did not present any sign of relapse, a new nasopharyngeal swab was negative, and the MTC metastatic disease was stable. Open in a separate window Fig. 1 Lung CT scan of the patient with COVID-19 and multimetastatic medullary thyroid cancer taking vandetanib: the interstitial thickening of the right lung, indicated by the white arrows, documented the mild pneumonia that the patient developed during the COVID-19 Discussion SARS-Cov-2 infection had a terrifying impact on all the world. More than 59 million of people got SARS-Cov-2 infections with more than 1,390,000 deaths. In face of the COVID-19 pandemic, researchers are urgently called to provide new.
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