Clinical presentation and in-hospital prognosis of lung cancer patients presenting with suspected and confirmed COVID-19

Abstract

We sought to compare the clinical presentation and prognosis of patients with lung cancer and confirmed COVID-19 infection to those with negative RT-PCR SARS-CoV-2 results. We included patients with confirmed lung cancer and suspected COVID-19 who presented to the emergency department. The primary outcome was in-hospital mortality and secondary outcomes included admission to intensive care unit (ICU) or mechanical ventilation. We analyzed the characteristics according to RT-PCR results and primary outcome. We constructed a logistic regression for each RT-PCR result group to find potential predictors of the primary outcome. Among 110 individuals with confirmed lung cancer (65±9 years, 51% male), 38 patients had positive RT-PCR and 72 patients had negative RT-PCR. There was no difference between groups for any clinical characteristic or comorbidities though individuals with confirmed COVID-19 had higher functionality in the ECOG scale. Leucocytes and lymphocytes were lower in individuals with positive tests. The primary outcome occurred in 58 (53%) individuals, 37 (34%) were admitted to the ICU, and 29 (26%) required mechanical ventilation. Although mortality was similar between the two groups, individuals with confirmed COVID-19 were significantly more likely to be admitted to the ICU or receive mechanical ventilation. Only lower lymphocytes and higher CRP were significantly associated with higher mortality. The clinical presentation of COVID-19 in lung cancer is not sufficient to identify higher or lower probability groups among symptomatic individuals, the overall mortality is high irrespective of RT-PCR results, and lymphopenia on admission was associated with the diagnosis and prognosis for COVID-19.

Prognostic Factors and Outcomes in Advanced Stage Lung Cancer Patients with COVID-19 Omicron Variant Infection

“…The incidence of severe illness and mortality rates in lung cancer patients with COVID-19 was reported to surge in the context of recent cancer treatment, likely attributed to chemotherapy-induced lymphocytopenia, which impairs cell-mediated immunity and further exacerbates virus-induced damage. 21 In our study, the average oxygen saturation on day 1 and day 7 remained at 76% and 71%, respectively, for the 3 patients who succumbed to the infection and the one unrecovered patient. Notably, these levels did not improve significantly despite aggressive treatment.…”

“…The incidence of severe illness and mortality rates in lung cancer patients with COVID-19 was reported to surge in the context of recent cancer treatment, likely attributed to chemotherapy-induced lymphocytopenia, which impairs cell-mediated immunity and further exacerbates virus-induced damage. 21 …”