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Journal article : Review

Endocrinology in the time of COVID-19: Clinical management of neuroendocrine neoplasms (NENs)

Abstract:
In viral pandemics, most specifically Covid-19, many patients with neuroendocrine neoplasms (NENs), including phaeochromocytomas, paragangliomas and medullary thyroid carcinoma, may develop Covid-19 in a mild or severe form, or be concerned about the influence of viral infection relative to their anti-tumoral therapy. In general, newly presenting patients should be assessed, and patients recently receiving chemotherapy, targeted therapy or radionuclide therapy, or showing tumour growth, should be closely followed. For previously diagnosed patients, who have indolent disease, some delay in routine follow-up or treatment may not be problematic. However, patients developing acute secretory syndromes due to functional neuroendocrine neoplasms (such as of the pancreas, intestine or lung), phaeochromocytomas and paragangliomas, will require prompt treatment. Patients with life-threatening Covid-19-related symptoms should be urgently treated and long-term anti-tumoral treatments may be temporarily delayed. In patients with especially aggressive NENs, a careful judgement should be made regarding the severity of any Covid-19 illness, tumour grade, and the immunosuppressant effects of any planned chemotherapy, immunotherapy (e.g. interferon-alpha), targeted therapy or related treatment. In other cases, especially patients with completely resected NENs, or who are under surveillance for a genetic disorder, a telephone or delayed consultation may be in order, balancing the risk of a delay against that of the possible development of Covid-19.
Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1530/eje-20-0424

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
RDM
Sub department:
RDM Strategic
Role:
Author
ORCID:
0000-0002-1438-3220


Publisher:
Bioscientifica
Journal:
European Journal of Endocrinology More from this journal
Volume:
183
Issue:
2
Pages:
G79-G88
Publication date:
2020-08-01
Acceptance date:
2020-06-09
DOI:
EISSN:
1479-683X
ISSN:
0804-4643
Pmid:
32554825


Language:
English
Keywords:
Subtype:
Review
Pubs id:
1113746
Local pid:
pubs:1113746
Deposit date:
2021-01-28

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