COVID-19&nbsp;&nbsp;&nbsp;

What is your preferred first-line treatment for chronic fatigue in patients with long COVID-19?

7 Answers available

Do you consider the use of tocilizumab in patients with COVID pneumonia who have had an improvement in supplemental O2 requirements but have significantly elevated inflammatory markers after day two of remdesivir and dexamethasone?

Do you consider use of convalescent plasma early in disease course in COVID-19 induced ARDS in mechanically ventilated patients?

Do the results of the recent study (Misset et al., PMID 37889107) showing reduction in 28-day mortality in patients with high neutralizing antibody ti...

What isolation policies are Rheumatology offices employing for both staff and patients diagnosed with COVID-19 given the new CDC guidelines?

CDC Healthcare Guidance CDC Isolation and Work Restriction Guidance CDC Immunocompromised Guidance

Do you use steroids in patients with respiratory failure who are infected with both influenza and COVID-19?

How do you approach which risk to accept given that steroids have evidence for use in COVID-19 while is suggestion for harm in using steroids in influ...

Do you use prednisone in the management of patients with persistent respiratory symptoms following acute COVID-19 infection?

4 Answers available

Is rituximab for refractory ITP contraindicated in the setting of an active COVID infection, particularly in a patient with asymptomatic COVID?

How do you approach Covid vaccine counseling in patients with rheumatic disease and history of pericarditis/serositis?

What steroid regimen do you employ in the treatment of patients with post COVID-19 pulmonary fibrosis?

In a patient with a bleeding disorder, how would one approach anticoagulation during active COVID infection?

Bleeding disorder such as vWD

Do you adjust immunosuppression in lung transplant recipients diagnosed with COVID-19?

Is there a role for antifibrotic therapy in post COVID-19 pulmonary fibrosis?

What is the difference between Multisystem Inflammatory Syndrome in Adults (MIS-A) and MAS/HLH?

Do you recommend using IL-1/IL-6 inhibitors in COVID-19 multisystem inflammatory syndrome in adults (MIS-A)?

What is your treatment paradigm for rectal cancer in the setting of COVID-19?

Are you doing more TNT to prolong time to surgery? If so, do are you starting with CRT or chemotherapy?

4 Answers available

How do you approach the timing of COVID-19 vaccination for patients with multiple sclerosis on B-cell depleting therapies?

Do you recommend routine use of Evusheld for pre-exposure prophylaxis for patients on immunosuppression?

Does treatment with B-cell depletion and/or negative anti-spike antibody status despite COVID mRNA vaccination influence your decision?

How have you been counseling patients with sickle cell regarding a 3rd COVID vaccine?

Should we recommend the COVID-19 booster vaccine to patients who had a DVT or any other complications such as hemolytic anemia or thrombocytopenia from prior vaccine doses?

In a patient with a heterozygous prothrombin gene mutation who has COVID with minimal symptoms, do you recommend prophylactic and/or therapeutic anticoagulation?

Are there any alternative, hypofractionated RT courses for patients with DLBCL that can be used during the COVID-19 pandemic?

Do you routinely check platelet counts after COVID-19 vaccines in patients with chronic ITP?

What is the longest acceptable interval between hysterectomy and vaginal cuff brachytherapy for high/intermediate risk endometrial cancer in the age of COVID-19?

Is there a role for antibody testing to confirm vaccine response for patients on rituximab after COVID-19 vaccination?

How will you use REGEN-COV (casirivimab/imdevimab-monoclonal antibody treatment recently approved under EUA as post-exposure prophylaxis for Covid) in rheumatic patients on immunosuppressive therapy?

Would you consider this for patients on B-cell depleting therapies or more broadly for other immunosuppressive agents?

What are your recommendations regarding methotrexate usage in patients with persistent chest CT changes post COVID pneumonia?

Would you have a different opinion based on whether it is a new therapy or an existing and previously well-tolerated therapy for the patient?

Do you recommend COVID vaccination in patients with antiphospholipid antibody positivity or other prothrombotic states not on anti-coagulation?

What hematologic conditions are contraindications for a COVID vaccine?

How are you timing the third dose of the COVID-19 mRNA vaccine in patients on rituximab?

In which patients with autoimmune or inflammatory conditions are you recommending a 3rd dose of the mRNA COVID vaccine?

Do you recommend that patients undergoing radiation treatment get a COVID vaccine booster?

If so, what patients do you recommend get one and do you have concerns for patients who also may be receiving chemotherapy as the CDC guidelines recom...

In which patients with oncologic or hematologic disorders are you recommending a 3rd dose of mRNA COVID vaccine?

How do you advise a patient with VTE on indefinite anticoagulants regarding the Ad26.COV2.S Johnson & Johnson/Janssen COVID vaccine?

Would you use autologous hematopoietic stem cells collected from a HR neuroblastoma patient found to be COVID positive after harvest?

Both the patient's nasopharyngeal swab and stem cells themselves resulted COVID positive post-harvesting.

How would you advise patients with known stable autoimmune thrombocytopenia regarding the Ad26.COV2.S (Johnson & Johnson/Janssen) vaccine?

How do you advise patients who had autoimmune diseases "triggered" by COVID infections on getting COVID vaccination?

E.g., inflammatory polyarthritis or inflammatory myopathy with onset within 2 weeks of documented COVID infection

Are there circumstances where you would recommend every 6 week dosing schedule for pembrolizumab monotherapy?

I am considering every 6 week pembrolizumab dosing in patients >70 years old in whom I want to reduce clinic visits for, especially in the context ...

Is the COVID-19 pandemic affecting your choice of high dose versus weekly cisplatin for definitive concurrent chemoradiation for HPV negative head and neck cancer?

What are the current official guidelines regarding COVID-19 vaccination for patients with cancer or for hematologic conditions?

Are there particular concerns related to the use of B-cell depletion therapies such as rituximab for rheumatic disease during the COVID-19 pandemic?

How would you time COVID-19 vaccination with someone on R-CHOP chemotherapy?

When would you recommended restarting biologic medications in an active RA patient after treatment with monoclonal antibodies, convalescent plasma or antiviral medications for a COVID-19 infection?

Are you offering hypofractionated comprehensive nodal irradiation following neoadjuvant chemotherapy for patients with locally advanced breast cancer in the setting of COVID-19?

What are best practices for radiation oncology patient and staff precautions with the COVID-19 pandemic?

I know many centers are exercising extra precautions in light of the new concerns with coronavirus. How are people explaining things to their patients...

12 Answers available

How long should breast cancer patients whose surgeries are delayed due to COVID-19 remain on neoadjuvant endocrine therapy?

For patients with low risk, early stage, HR+/HER2- breast cancer who initiated endocrine therapy in order to delay their surgery due to the COVID 19 e...

Are you recommending tocilizumab for any COVID-19 patients?

Current guidelines do not support its use, but the EMPACTA trial suggests it may be effective in a subpopulation of patients.

Are you recommending the mRNA COVID-19 vaccines to your patients with immune mediated inflammatory diseases?

What is your strategy for having COVID positive patients resume infusions after they have recovered from the infection?

Is there an increased risk of COVID-19 in patients on immunosuppressants?

Is there a valid hypofractionated regimen for postop cervical/endometrial cancers given COVID-19?

Are there scenarios that new visits/consults with patients can be done virtually amidst the COVID-19 outbreak?

6 Answers available

How will your management of head and neck cancers change with the COVID-19 pandemic?

Are you employing more or less primary chemoRT v. surgery for some cancers? Are you dose de-escalating? What are issues radiation oncologists should b...

6 Answers available

How long can you delay the start of radiation in a patient who has received adjuvant chemotherapy after lumpectomy/mastectomy?

Should new patients requiring chemotherapy be tested for COVID-19 prior to starting treatment?

Do you recommend that children with sickle cell disease refrain from returning to school during the COVID-19 pandemic?

In the setting of COVID-19, would you perform a SLNB for a patient incidentally found to have microinvasive ER+ ILC in contralateral prophylactic mastectomy following neoadjuvant chemotherapy for a locally advanced triple positive breast cancer?

How do you approach the decision of whether and when to initiate therapy in patients who remain COVID-19 positive >2 weeks after infection but are asymptomatic from the virus?

E.g. a patient with progression of their primary cancer but still is testing COVID19+ over a month after infection?

Are there any trials currently studying low-dose RT for confirmed COVID-19 infections with associated pneumonia?

Would you consider it off-trial during the pandemic? There is some older data for treatment of pneumonia with single-fraction low-dose radiotherapy, w...

Is there an increased risk of pneumonitis in COVID-19+ patients receiving lung irradiation?

Any differences in the risks between SBRT vs. conventionally fractionation? Concurrent immunotherapy?

Should we be utilizing prophylactic G-CSF in our patients with intermediate risk of febrile neutropenia due to the COVID-19 pandemic?

Are you placing more weight on patient risk factors such as age >65 or co-morbidities?

What are best practices for pediatric hematology/oncology patient and staff precautions with the COVID-19 pandemic?

How are you changing your parent/visitor policies? Are you testing for COVID-19 in all febrile patients? Has COVID-19 changed the care settings...

Would you hold rituximab for newly diagnosed B-cell lymphoma if the patient is COVID-19 positive?

What if the patient has a history of confirmed COVID-19 but has since recovered?

Should maintenance rituximab be held due to COVID-19 in patients with advanced bulky follicular lymphoma who attain a PR/CR to weekly rituximab?

Should patients about to start radiation be required to have COVID-19 testing, if resources are available?

Our hospital is currently testing (PCR) for COVID-19 in all inpatients and outpatients undergoing surgical/"aerosolizing" procedures. Since radiation ...

What is the most appropriate dose-fractionation for an early stage, progressive cutaneous squamous cell carcinoma of the nose in an elderly/frail patient in the setting of the COVID-19 pandemic?

How do counsel patients regarding potential for cartilage necrosis?

Would you consider short course RT for rectal cancer in the post-op setting given COVID-19?

What neoadjuvant therapy would you choose for a post menopausal woman with ER negative, PR positive high grade node negative breast cancer?

Would you consider genomic assays before neoadjuvant chemotherapy? How would you modify your treatment given the COVID-19 pandemic?

Would you stop current immunosuppressive therapy or delay starting immunosuppressive therapy in a patient with aplastic anemia who has been infected with COVID-19?

Would you recommend anticoagulation prophylaxis for a pediatric patient admitted with COVID-19?

Are patients with bleeding disorders receiving plasma-derived products at increased risk of acquiring COVID-19?

Should patients with bleeding disorders increase their home supplies of clotting factors foreseeing a possible shortage of product availability due to COVID-19?

How would you manage a patient with sickle cell disease who is infected with COVID-19?

What are best practices for taking care of lung cancer patients during the COVID-19 pandemic?

4 Answers available

What is your preferred neoadjuvant chemotherapy (FOLFIRINOX vs gemcitabine/nab-paclitaxel) and duration for a resectable T2N1 pancreatic adenocarcinoma in a fit patient whose surgery has been cancelled due to COVID-19 risk in the hospital?

Due to the thrombotic nature of COVID-19, should we be discontinuing tamoxifen temporarily in patients with an active infection?

In a locoregionally advanced breast cancer with multiple positive surgical margins, how safe is it to wait for a re-excision vs treating upfront with comprehensive RT if surgery cannot be done the short term due to the COVID outbreak?

Radiation in the setting of positive margins is sub-optimal and from my understanding high boost doses do not replace further surgery. Is it better to...

What oral alternatives would you recommend as opposed to injectable GnRH agonists for those who do not wish to come to clinic due to COVID-19?

This applies to both de novo cases and patients who have previously received injectable agents.

Are you covering the tracheostomy site with a surgical mask due to COVID-19 to protect the therapist?

Please see this article for referrence https://www.sciencedirect.com/science/article/pii/S0167814020301638

Would you withhold immunotherapy for ES-SCLC during the COVID-19 pandemic?

What are the risks of infection with COVID-19 if using immunotherapy?

Given COVID-19, is there a good hypofractionated regimen for postmastectomy radiation for locally advanced breast cancer?

Should our selection for neoadjuvant chemotherapy in ovarian cancer patients change in light of COVID-19?

Would you choose neoadjuvant endocrine therapy for a low grade, node negative, ER/PR positive, breast cancer given delays in definitive surgery due to the COVID-19 pandemic?

Would your choice vary based on the patient's gender?

Are maintenance therapies for ovarian cancer being held at your institution due to COVID-19?

How are you modifying your current sarcoma-directed therapy in the setting of the COVID-19 pandemic?

For example, would you consider switching to an outpatient regimen in lieu of AIM for metastatic soft tissue sarcoma?

Are you altering your use of immune checkpoint inhibitors given the risk of immune-related pneumonitis and the COVID-19 outbreak?

In light of the COVID-19 pandemic, would you consider SBRT for appropriately selected early stage breast cancer patients?

Many hormone positive patients are beginning hormone therapy until they can go to surgery. With a prolonged pause in routine procedures seeming very l...

How should you manage a COVID-19 infected/suspected patient who is receiving chemotherapy and cannot interrupt or delay their cancer treatment?

Can we use a linear accelerator to sterilize PPE?

How has COVID-19 altered your recommendations for invasive mediastinal staging for NSCLC?

Should staging and treatment decisions be made based on imaging alone?

How should our selection for neoadjuvant chemotherapy for breast cancer change in light of COVID-19?

In light of promising results of hydroxychloroquine in COVID-19, should we consider using it prophylactically in cancer patients, especially if immunocompromised?

Acknowledging that there is no time for good trials yet in this setting

Given the current COVID-19 pandemic, how long would you delay mastectomy post neoadjuvant chemotherapy?

Would the recommendation differ based on HR+ vs. TNBC vs HER2+ classification? Would you recommend against immediate breast reconstruction?

For patients who meet criteria to be treated with 3 months of CAPEOX based on IDEA study, is it reasonable to use capecitabine alone for 3 months and drop oxaliplatin during the COVID pandemic?

Given that majority of benefit is derived from the capecitabine, would this be an acceptable option to decrease patient contact with the healthcare sy...

Would you consider modifying T&O fractionation during the COVID-19 pandemic?

What dose/fractionation would you recommend?

What are best practices for medical oncology clinics during the COVID-19 pandemic?

How would you approach adjuvant therapy in a patient with HR+ breast cancer with a high RS (>25) given the current COVID-19 pandemic?

Would you consider delaying chemotherapy and proceeding only with endocrine for now?

Are you altering your use of Active Breathing Coordination for breath hold technique patients in light of the COVID-19 pandemic?

With COVID-19 worries, are you more likely to offer women with endometrial cancer vaginal cuff brachytherapy over EBRT?

In the wake of the COVID-19 pandemic, are there any hypofractionated regimens (without concurrent chemotherapy) that could be utilized for head /neck cancer in a post operative setting?

How would you boost a high-risk prostate cancer patient who received standard fractionation treatment and is not able to get LDR boost given COVID-19?

Would you use SBRT, hypofractionated or standard fractionated boost?

How should you manage a coronavirus infected/suspected patient who is receiving radiotherapy and cannot interrupt or delay their cancer treatment?

How would you approach a patient who is receiving chemoRT but has confirmed COVID-19 with minor symptoms, as breaking treatment for 2 weeks quarantine...

7 Answers available

What are the current official guidelines regarding managing patients during COVID-19?

Are you more inclined to use neoadjuvant endocrine therapy over neoadjuvant chemotherapy or upfront surgery for your ER+HER2- breast cancer patients during the COVID19 pandemic?

Personally, my practice is to guide patients directly to surgery or to do neoadjuvant chemotherapy rather than to do neoadjuvant endocrine therapy, bu...

Should extra precautions be taken for pediatric oncology patients in light of the recent COVID-19 outbreak?

A case report (https://www.ncbi.nlm.nih.gov/pubmed/32149486) describes severe COVID-19 infection in a pediatric oncology patient. Have you seen simil...

Will patients who receive radiation to a large mediastinal nodal field have an increased susceptibility to COVID-19?

If so, for how long would you expect this increased susceptibility to last? Our medical oncologists often tell patients that their lymphocyte counts m...

How should radiation oncology departments prepare for significant resource depletion and/or staff shortages with the COVID-19 outbreak?

Are your practices adjusting priorities at this time? If so, what adjustments are you making? If not, do you have metrics in place that will tell you ...

Should we consider deferring adjuvant chemotherapy for resected early-stage NSCLC in light of COVID-19?

If so, how long is too long to wait?

Should we delay adjuvant breast radiotherapy for early stage breast cancers as the COVID-19 situation evolves?

Would your practice vary based on hormone receptor or Her2 status?

How should you manage a pediatric oncology patient who has an ANC > 500 and a normal chest x-ray but is confirmed to be infected with COVID-19 and is immunosuppressed from chemotherapy?

Should the patient be admitted for observation which will risk exposing other immunocompromised patients to COVID-19, or should the patient be quarant...

What is the longest acceptable interval between radical orchiectomy and adjuvant BEP for Stage IIB/III pure seminoma in the age of COVID-19?

Should I wear gloves during a routine physical exam on an asymptomatic patient with no risk factors for COVID-19?

How would you approach missed doses of fulvestrant due to COVID-19?

What measures should we take regarding routine follow-up visits for well patients in surveillance during the coronavirus pandemic?

When a physical exam is important and telehealth is not a good option, should we be proactive and reschedule or should we continue to see them as sche...

Should we be stopping new starts of patients who can be triaged for 2-3 months like prostate cancers on ADT when significant community spread of COVID-19 is detectable in our area?

Mitigating the spread of COVID-19 is of utmost priority now that containment measures have failed. Social distancing will help "flatten the curve" of ...

9 Answers available

Is there any consensus or guidance on how to manage germ cell tumor patients in the COVID-19 era?

What scenarios, if any, are you delaying adjuvant chemotherapy in light of the COVID-19 outbreak?

Have your treatment recommendations for urothelial cancer patients changed given the ongoing COVID19 pandemic?

Would you forego neoadjuvant chemotherapy? Are you using growth factor support differently? Any changes to immunotherapy? Other considerations?

Is your approach to managing immune related adverse events altered at all in light of COVID-19?