Observational studyInternational journal of clinical oncology2025
Impact of prior COVID-19 infection on perioperative outcomes in non-small cell lung cancer patients: a prospective observational cohort study.
Observational study in International journal of clinical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCOVID-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.
methodsThis 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.
resultsAmong 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.
conclusionPrior 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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