A false alarm of COVID-19 pneumonia in lung cancer with anti-PD-1 related pneumonitis: a case report and review of the literature

Abstract Background Pneumonitis belongs to the fatal toxicities of anti-PD-1/PD-L1 treatments. Its diagnosis is based on immunotherapeutic histories, clinical symptoms, and computed tomography (CT) imaging. The radiological features were typically ground-glass opacities, similar CT presentation 2019 Novel Coronavirus (COVID-19) pneumonia. Thus, clinicians are cautious in differential especially COVID-19 epidemic areas. Case Herein, we report a 67-year-old Han Chinese male patient presenting with dyspnea normal body temperature 15th day close contact his son, who returned from Wuhan. He was diagnosed as advanced non-small cell lung cancer developed pneumonitis post Sintilimab injection during COIVD-19 pandemic period. chest indicated peripherally subpleural lattice opacities at inferior right lobe bilateral thoracic effusion. swab samples taken twice within 72 hours real-time reverse-transcription polymerase-chain-reaction (RT-PCR) results negative. thereafter treated prednisolone antibiotics for over 2 weeks. suspicious lesion has almost absorbed according imaging, consistent prominently falling CRP level. anti-PD-1 related mixed bacterial infection clinically laboratory evidences good response antibiotics. Conclusion pneumonia possess presentations imaging features. Therefore, depends epidemiological immunotherapy RT-PCR tests. glucocorticoid still controversial but helpful diagnosis.