A tale of two coughs.

The first reported case of COVID-19 in NYC was on March 1, 2020. Since then, making a clinical diagnosis of radiation pneumonitis has become dicier at MSKCC. Here’s a case series of four patients evaluated for radiation pneumonitis throughout the month of March, all 8-16 weeks out from completion of radiation for locally-advanced lung cancer. All presented with worsening dyspnea and cough, and two had fever. Most received empiric steroids, but only one improved—the only one to subsequently test negative for COVID-19. TBL: Initial assessment of all suspected radiation pneumonitis cases during this pandemic should include COVID-19 testing because symptoms and imaging findings virtually mirror one another while appropriate treatments do not. | Shaverdian, Adv Radiat Oncol 2020