Hanbo Pan, Fan Shen, Ningyuan Zou, Yu Tian, Jiaqi Zhang, Yixing Tao, Hongda Zhu, Jia Huang, Qingquan Luo
{"title":"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","authors":"Hanbo Pan, Fan Shen, Ningyuan Zou, Yu Tian, Jiaqi Zhang, Yixing Tao, Hongda Zhu, Jia Huang, Qingquan Luo","doi":"10.1007/s10147-025-02836-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1953-1962"},"PeriodicalIF":2.8000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of prior COVID-19 infection on perioperative outcomes in non-small cell lung cancer patients: a prospective observational cohort study.\",\"authors\":\"Hanbo Pan, Fan Shen, Ningyuan Zou, Yu Tian, Jiaqi Zhang, Yixing Tao, Hongda Zhu, Jia Huang, Qingquan Luo\",\"doi\":\"10.1007/s10147-025-02836-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":13869,\"journal\":{\"name\":\"International Journal of Clinical Oncology\",\"volume\":\" \",\"pages\":\"1953-1962\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Clinical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10147-025-02836-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10147-025-02836-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/23 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Impact of prior COVID-19 infection on perioperative outcomes in non-small cell lung cancer patients: a prospective observational cohort study.
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.
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.
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