Risk of conversion and severe postoperative complications in older patients with non-small cell lung cancer and a history of COVID-19: a population-based study
Year: 2023
Type: article
Study design: Observational Study
Abstract: Background: Older adult patients are more prone to long-term complications from coronavirus disease 2019 (COVID-19) and are generally more vulnerable during lung surgery compared to younger individuals. This study aimed to determine whether a past COVID-19 infection elevates surgical difficulty and risk for older adult patients with non-small cell lung cancer (NSCLC), identify high-risk post-COVID-19 subgroups, and preoperatively predict surgical difficulty and risk. Methods: Patients with clinical T1-3N1-2M0 NSCLC, aged ≥65 years, and with a history of COVID-19 (PCOV group) or without one (NCOV group) who underwent curative surgery at seven tertiary health care institutions in China between 2021 and 2024 were retrospectively included. The surgical difficulty and risk were measured according to the incidence of conversion and severe postoperative complications (Clavien-Dindo grade ≥III), respectively. Propensity-score matching (PSM) was used to mitigate patient selection bias. Prediction models were developed to preoperatively forecast the risk of conversion and severe complications. Results: 18.7%; P=0.03) and respiratory complications. Stratified analysis indicated that previous infection with COVID-19 significantly increased the risk of severe complications in patients aged ≥75 years (OR =1.312; 95% CI: 1.013-1.799) and heavy smokers (OR =1.297; 95% CI: 1.022-1.639). Finally, the nomograms developed to predict the surgical difficulty and risk for patients with a history of COVID-19 and for high-risk populations demonstrated good performance. Conclusions: Past COVID-19 infection does not significantly increase surgical difficulty or risk for older adult patients with NSCLC. However, heavy smokers and those aged ≥75 years face elevated surgical risks following COVID-19 infection. The proposed preoperative prediction models can effectively forecast surgical difficulties and risks for older adult patients with NSCLC.
Authors: Hanbo Pan, Ye Dong, Yeqin Guo, Ling Li, Wanyu Li, Jiaqi Zhang, Haizhen Jin, Weicheng Kong, Hang Chen, Zhen Ge, Yu Tian, Junwei Ning, Zhiyuan Bao, Qiyang Qiu, Difan Zhang, Yixing Tao, Fan Shen, Weiqiu Jin, Guomo Ruan, Zongxiang Duan, Min Zheng, Liang Fang, Chengwei Zhou, Guodong Xu, Ming Zhang, Jia Huang, Hui Yin, Qingquan Luo, Hui Wang
Institutions: Shanghai Jiao Tong University, Shanghai Chest Hospital, Shanghai First People's Hospital, Ningbo University, Ningbo Medical Center Lihuili Hospital, Ningbo University Affiliated Hospital, Ningbo First Hospital, Tongren Hospital, Zhejiang University, XinHua Hospital, University of Electronic Science and Technology of China, Sichuan Cancer Hospital, Shanghai University, Wenzhou City People's Hospital, Shaoyang University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414394165