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In recent years, immune checkpoint inhibitor (ICI) use to treat multiple cancers has increased in oncology, but equally has raised the question of whether ICI therapy and its side\u2010effects is harmful or beneficial during this pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A combination of published literature in PubMed between January 2010 and December 2020, recommended guidelines in non\u2010cancer patients, and clinical experience was utilized to outline recommendations on glucocorticoid timing and dosing regimens in ICI\u2010treated patients presenting with AI during this COVID\u201019 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The potential immune interaction between ICIs and COVID\u201019 require major consideration because these agents act at the intersection between effective cancer immunotherapy and increasing patient susceptibility, severity and complications from the SARS\u2010CoV\u20102 sepsis. Furthermore, ICI use can induce autoimmune adrenal insufficiency (AI) that further increases infection susceptibility. Thus, ICI\u2010treated cancer patients with AI may be at greater risk of COVID\u201019 infection. Glucocorticoids are the cornerstone for replacement therapy, and for treatment and mitigation of adrenal crisis and relief of mass effects in ICI\u2010related hypophysitis. High\u2010dose glucocorticoids have also been used with cytotoxic chemotherapy as part of cancer treatment, and iatrogenic AI may arise after glucocorticoid discontinuation that increases the risk of adrenal crisis. Furthermore, in patients who develop the \u201clong COVID\u201019\u201d syndrome, when to discontinue glucocorticoid therapy becomes crucial to avoid unnecessary prolongation of therapy and the development of iatrogenic hypercortisolemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>During the COVID\u201019 pandemic, much of cancer care have been impacted and an important clinical question is how to optimally manage ICI\u2010related AI during these unprecedented times. Herein, we suggest practical recommendations on the timing and dosing regimens of glucocorticoids in different clinical scenarios of ICI\u2010treated cancer patients presenting with AI during this COVID\u201019 pandemic.<\/jats:p><\/jats:sec>","DOI":"10.1002\/edm2.246","type":"journal-article","created":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T13:31:01Z","timestamp":1615210261000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Rethinking the management of immune checkpoint inhibitor\u2010related adrenal insufficiency in cancer patients during the COVID\u201019 pandemic"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8169-2728","authenticated-orcid":false,"given":"Kevin C. 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