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COVID-19与肺癌及肺癌治疗后继发性疾病的鉴别

Difference between lung cancer, treatment-related diseases and COVID-19

Disease	History	Symptom	Laboratory data	Image study
COVID-19: 2019 novel coronavirus disease; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; PD-1: programmed cell death protein 1; PD-L1: programmed cell death protein ligand 1; CTLA-4: cytotoxic T lymphocyte associated antigen 4.
COVID-19[4, 5, 21]	Epidemiological history	Fever, sore throat, muscle ache, fatigue, cough, and may be accompanied by dyspnea in severe cases	Leucocytes↓ Lymphocytes↓ SARS-CoV-2 test (+)	Single or multiple mottling or ground-glass opacity or condensation shadows in bilateral lung, mainly in the peripheral lung, and pleural suffusion is rare
Lung cancer with obstructive pneumonia[29]	Lung cancer history	No special symptoms, and may shows as fever, cough and shortness of breath	Leucocytes↑ Neutrophils↑ Procalcitonin↑ Bacteriology test (+)	Bronchial stenosis or occlusion in the proximal part of the lesion and pulmonary atelectasis or infiltration or condensation shadows in the distal part of the lesion
Radiation pneumonia[30]	Radiotherapy history, mostly happened in 1 mon-3 mon after radiation	Cough usually precedes fever, and may be accompanied by dyspnea in severe cases	No special	Mottling or ground-glass opacity or condensation shadows in the radiation field
Drug-induced interstitial pneumonia[31, 32]	Chemotherapy or molecular targeted therapy history	Progressive dyspnea and cough	No special	Widespread patchy or diffuse consolidation or ground-glass opacity with or without intralobular reticular opacity and septal thickening
Immune checkpoint inhibitor therapy-related pneumonitis[33]	Treatment history of PD-1, PD-L1 or CTLA-4	Cough and dyspnea are usual, and fever is rare	No special	Multiple or diffuse ground-glass opacity or mesh shadow or condensation shadows in lung