Impact of Coronavirus Disease 2019 on Clinical Characteristics in Patients With Lung Cancer: A Large Single-Centre Retrospective Study

Abstract

Lung cancer is the most common cancer malignancy worldwide. With the continuous spread of the coronavirus disease 2019 (COVID-19) globally, it is of great significance to explore the impact of this disease on the clinical characteristics of lung cancer. Thus, we aimed to investigate whether the COVID-19 pandemic had any influence on the clinical characteristics and diagnosis of patients with lung cancer. We collected clinical and demographic data of patients who were newly diagnosed with lung cancer at our hospital between February 2019 and July 2020. Overall, 387 patients with lung cancer were divided into two groups for analysis: epidemic group (from February to July 2020) and pre-epidemic group (from February to July 2019). The source of diagnosis and clinical characteristics of the two groups were analysed. T-test and Mann-Whitney U were used for continuous variables, and Chi-squared or Fisher’s exact test for categorical variable. We found that during the epidemic period, 110 cases of lung cancer were incidentally diagnosed during COVID-19 screening, accounting for 47.6% of all newly diagnosed lung cancer cases at our hospital. The proportions of patients who were diagnosed based on symptoms and physical examination in the epidemic group were 34.2 and 18.2%, respectively, while that in the pre-epidemic group were 41.7 and 58.3%, respectively. There was significant difference in the source of diagnosis between the two groups. In a subgroup analysis of the epidemic group, the average tumour volume of the patients diagnosed with COVID-19 screening was significantly smaller than that of the patients diagnosed with symptoms and physical examination. In conclusion, the continuation of the COVID-19 pandemic may impact the screening and clinical characteristics of lung cancer and require large-scale and longer-term observation.

Delayed Diagnosis and Treatment of Cancer Patients During the COVID-19 Pandemic in Henan, China: An Interrupted Time Series Analysis

“…The prevention and control policies for controlling the spread of the virus taken by hospitals have played a positive role but have also impacted the treatment of other diseases. Cancer patients are of particular concern because they especially need timely treatment and diagnosis ( 7 ). Mounting evidence shows that the diagnosis and treatment of cancer were delayed during the pandemic ( 8 ), which may increase the likelihood of cancer metastasis or lead to progression from a curable to an incurable state ( 9 ).…”

The impact of the COVID-19 pandemic on the lung cancer diagnosis

“…In our study, it was found that the average age of lung cancer during the pandemic period was younger. In a study conducted in China during the pandemic, lung cancer patients during the pandemic were significantly younger 12 . Curfews over the age of 65 and fear of infection may have an impact on hospital admissions.…”

“…The pandemic did not change the lung cancer metastasis rates of patients. In similar studies, the pandemic did not cause major stage changes in lung cancer [10][11][12] .…”

Real-world evidence of safety and influence for lung cancer surgery under COVID-19 pandemic in Japan

“…In the United Kingdom, referrals for cancer-suspected cases decreased by about 80% (7,17). The potential causes of these delays in diagnosis and treatment are the limitations in hospital resources and the hesitancy of patients to receive necessary health care services during the COVID-19 pandemic (18,19). According to a study of lung cancer patients who participated in clinical trials during the SARS outbreak, 64% of patients were hesitant to visit a hospital due to fear of infection, and 4% of patients decided to cease all treatment because of infection issues.…”