CD274 and heart failure: Late-onset cases may occur because PD-1 and PD-L1 remain occupied for >1 year after the last infusion of the ICI.6 One cohort study indicated that heart failure with LV systolic dysfunction was more common in late-onset cases; thus, there may be a possible mechanism for sustained myocardial damage by the dysregulation of cardiomyocyte Ca2+ currents.7 We reported a unique case with late-onset cardiac manifestations of irAE immediately after the SARS-CoV-2 infection, despite stable ICI treatments for 7 months; it led us to consider that the SARS-CoV-2 infection might act as a trigger.