Early detection of SARS-CoV-2 from staging PET-CT

Area of Science:

• Oncology
• Infectious Diseases
• Radiology

Background:

• SARS-CoV-2 (COVID-19) can present asymptomatically or with mild symptoms.
• Cancer patients may have incidental findings of SARS-CoV-2 on routine imaging.
• Management of cancer patients with concurrent SARS-CoV-2 infection undergoing chemoradiation is challenging.

Purpose of the Study:

• To highlight the potential for subclinical SARS-CoV-2 infection detection via routine imaging in cancer patients.
• To discuss the implications of SARS-CoV-2 on cancer treatment planning, specifically chemoradiation.

Main Methods:

• Case study of a mildly symptomatic anal cancer patient diagnosed with SARS-CoV-2.
• Utilized PET-CT scan for cancer staging, which revealed infectious pulmonary findings.
• Confirmed SARS-CoV-2 infection via viral polymerase chain reaction.

Main Results:

• PET-CT scan showed pulmonary changes suggestive of infection, not malignancy.
• Patient experienced new-onset anosmia, prompting SARS-CoV-2 testing.
• Chemoradiation was postponed to prevent myelosuppression during active viral infection.

Conclusions:

• Oncologists should maintain a high suspicion for subclinical SARS-CoV-2 in cancer patients undergoing staging imaging.
• Multidisciplinary discussion and risk-benefit analysis are essential before initiating immunosuppressive therapies like chemoradiation.
• Delaying treatment can prevent severe pneumonia and hospitalization in COVID-19 positive cancer patients.