Table 1.

The Differences Between EGFR TKI–Associated ILD and COVID-19 Infection

	Gefitinib	Erlotinib	Afatinib	Osimertinib	COVID-19 Infection
Incidence, (%)	Overall 1.3¹ Japan 1.6–4.3; non-Japanese 0.3–1	1.1%–4.3	1.6	3.9	—
Interval to onset	Median time 24–42 d; majority within 4–8 wk.	Median time 39 d; majority within 4 wk.	Median time 26.5 d (in Japan)	Median time 54 d (14–240 d)	Median incubation period of 5.1 d, with 97.5% becoming symptomatic within 11.5 d
Mortality	13%–50%¹				6.95% (to April 25, 2020)
CXR	NA				33.3%–69% patients positive with COVID-19 had abnormalities on CXR³ 47%–80% consolidation, 20%–38% GGO The severity of CXR peaked at 10–12 d from symptom onset.³
Chest CT	Includes four patterns as below² A nonspecific area with GGO. A multifocal area of airspace consolidations. Patchy distribution of GGO accompanied by interlobar septal thickening. Extensive bilateral GGO or airspace consolidations with traction bronchiectasis.				Bilateral distribution of GGO with or without consolidation in posterior and peripheral lungs was the cardinal hallmark of COVID-19. Included the following patterns⁴: GGOs 14%–98%; consolidation 2%–64%; GGO + consolidation 19%–59%; interlobular septum thickening 1%–75%; reticular pattern 1%–22%; crazy paving 5%–36%; air bronchogram 21%–80%; bronchial wall thickening 11%–23%; pleural thickening 32%; subpleural line 20%; nodules 3%–13%; reversed halo sign 2%–3%; pleural effusion or pericardial effusion 1%–8%; lymphadenopathy 4%–8%
Diagnosis	Diagnosis of EGFR TKI–associated interstitial pneumonitis is made essentially by exclusion of others				RT-PCR, isothermal amplification assays, serology tests
Symptoms	Nonspecific, dyspnea 94.3%, fever 51.4%, cough 20%, asymptomatic 5.7%				Fever 85%–90%, cough 65%–70%, fatigue 35%–40%, sputum production 30%–35%, shortness of breath 15%–20%, myalgia or arthralgia 10%–15%, headaches 10%–36%, sore throat 10%–15%, chills 10%–12%.
Treatment	Early detection, discontinue EGFR TKI, and start high-dose steroids as soon as possible.				No FDA-approved drugs as yet. Steroids may be harmful⁵

COVID-19, coronavirus disease 2019; CXR, chest radiograph; FDA, Food and Drug Administration; GGO, ground-glass opacity; ILD, interstitial lung disease; NA, not applicable; RT-PCR, reverse transcriptase-polymerase chain reaction; TKI, tyrosine kinase inhibitor.