Impact of prior COVID-19 infection on perioperative outcomes in non-small cell lung cancer patients: a prospective observational cohort study.

IF 2.8 3区医学 Q3 ONCOLOGY

International Journal of Clinical Oncology Pub Date : 2025-10-01 Epub Date: 2025-07-23 DOI:10.1007/s10147-025-02836-9

Hanbo Pan, Fan Shen, Ningyuan Zou, Yu Tian, Jiaqi Zhang, Yixing Tao, Hongda Zhu, Jia Huang, Qingquan Luo

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引用次数: 0

Abstract

Background: COVID-19 infection may induce persistent pulmonary sequelae, potentially elevating perioperative risks in non-small cell lung cancer (NSCLC) patients. This study aims to evaluate the impact of prior COVID-19 infection on perioperative outcomes in NSCLC patients undergoing lung resection.

Methods: This prospective observational cohort study enrolled NSCLC patients undergoing surgery at Shanghai Chest Hospital (May 2024-January 2025). Patients were stratified into COVID-19-exposed (PCOV) and non-exposed (NCOV) cohorts. The primary endpoint: 30-day postoperative pulmonary complications (PPCs); secondary endpoints: surgical duration and postoperative hospital stay. Propensity-score matching (PSM; 1:1 ratio) was performed to address confounders.

Results: Among 2285 enrolled patients (NCOV: 913; PCOV: 1372), PSM yielded 762 matched pairs with balanced baseline characteristics. The PCOV group exhibited significantly higher 30-day PPC rates (Unmatched: 18.0% vs. 10.4%, P < 0.001; Matched: 17.3% vs. 10.8%, P < 0.001), prolonged surgical durations (Unmatched: 108.6[86.0-128.2] vs. 123.6[93.7-139.0], P < 0.001; Matched: 111.8[87.4-129.1] vs. 121.1[92.8-138.2], P < 0.001; mins, median[interquartile range(IQR)]) and extended postoperative hospital stays (Unmatched: 4[4-5] vs. 5[4-6], P < 0.001; Matched: 4[4-5] vs. 5[4-6], P < 0.001; days, median[IQR]) compared to the NCOV group. Other perioperative outcomes were comparable between the groups. Stratified analyses demonstrated elevated 30-day PPC risk in all predefined PCOV subgroups except patients aged ≤ 65 years (Unmatched: 1.312[0.919-1.873], P = 0.135; Matched: 1.302[0.846-2.004], P = 0.230; odds ratio [95% confidence interval]). Further analysis for patients aged ≤ 65 years showed that the PCOV group exhibited no significant differences in perioperative outcomes compared to the NCOV group, except for surgical duration.

Conclusion: Prior COVID-19 infection is associated with increased PPCs, longer operative times, and delayed discharge in NSCLC patients. However, perioperative outcomes remained comparable in patients ≤ 65 years, suggesting age-dependent resilience to COVID-19-related surgical risks.

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既往COVID-19感染对非小细胞肺癌患者围手术期结局的影响：一项前瞻性观察队列研究

背景：COVID-19感染可能诱发持续性肺部后遗症，潜在地增加非小细胞肺癌（NSCLC）患者的围手术期风险。本研究旨在评估既往COVID-19感染对行肺切除术的NSCLC患者围手术期预后的影响。方法：本前瞻性观察队列研究纳入了2024年5月- 2025年1月在上海胸科医院接受手术的非小细胞肺癌患者。将患者分为covid -19暴露组（PCOV）和非暴露组（NCOV）。主要终点：术后30天肺部并发症（PPCs）；次要终点：手术时间和术后住院时间。倾向分数匹配；1:1比例)处理混杂因素。结果：在2285例入组患者中(NCOV: 913例；PCOV: 1372)， PSM得到762对基线特征平衡的配对。PCOV组30天PPC率显著高于非小细胞肺癌（Unmatched: 18.0% vs. 10.4%， P）。结论：先前的COVID-19感染与NSCLC患者PPC升高、手术时间延长和延迟出院有关。然而，≤65岁患者的围手术期结果仍然具有可比性，这表明年龄依赖性对covid -19相关手术风险的恢复能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Clinical Oncology 医学-肿瘤学

CiteScore

6.80

自引率

3.00%

发文量

175

审稿时长

2 months

期刊介绍： The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.