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Case report
Haemodialysed patient with lung cancer in the COVID-19 era: a clinical challenge
  1. Tomás de Paiva Carvalho1,
  2. Francisco Trinca2,
  3. Teresa Cardoso3 and
  4. Rui Dinis2
  1. 1Clinical Oncology, Hospital do Espírito Santo EPE, Evora, Portugal
  2. 2Medical Oncology, Hospital do Espirito Santo de Evora EPE, Evora, Portugal
  3. 3Pulmonogy, Hospital do Espírito Santo EPE, Evora, Portugal
  1. Correspondence to Dr Tomás de Paiva Carvalho; tcarvalho{at}hevora.min-saude.pt; Dr Francisco Trinca; francisco_trinca{at}hotmail.com

Abstract

A 66-year-old man was referred to the oncological pneumology consultation due to a mass in the right upper lobe observed in a routine X-ray of the chest. The CT scan confirmed a mass in the same location. The biopsy revealed a lung adenocarcinoma. It was decided to start chemotherapy adapted to kidney function. In April 2020, the patient contracted SARS-CoV-2 infection and developed bilateral pneumonia with partial respiratory failure. He was transferred to the intensive care unit, where he had a positive evolution. In the next 5 months, there was a clinical improvement; however, the CT scan of the chest showed disease progression. After a new multidisciplinary approach, it was decided to start a second line with atezolizumab. After four cycles of atezolizumab, there was a clear clinical improvement, and a reduction by more than 50% in the tumour size, without significant adverse effects.

  • lung cancer (oncology)
  • COVID-19
  • immunological products and vaccines
  • chemotherapy
  • lung function

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-243462

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    Footnotes

    • Contributors TdPC was the main author of this article and responsible for the clinical case description and final draft. TC was responsible for the articles review and theoretical basis description. FT and RD were responsible for the review of the case, each focusing on their speciality. The authors also provided clinical care to the patient during the described admissions.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.