What precautions or modifications, if any, would you employ when considering lung SBRT for early NSCLC in a patient recovering from acute lung injury?

For a patient recovering from COVID-19 pneumonia, I would hold SBRT until the patient has recovered fully from acute infection, i.e., no more fever, cough, and/or SOB. The patient's breathing should recover to close to pre-COVID-19 pneumonia status and chest CT image showed resolution of COVID-19 acute inflammation.

It is possible that some patients might still have "scar" from COVID-19 pneumonia after the clinical recovery, it is the clinician's judgment call to decide the time of SBRT. In addition, it is always helpful to be cautious about SBRT planning and DVH analysis. Conservative estimation of lung tolerance is advisable.