Clinical management of lung cancer patients with respiratory symptoms during the COVID-19 pandemic.

Abstract

ObjectiveThere are many clinical conditions, such as lung cancer, that need to be followed up and treated during a pandemic. Providing health care for patients who are immune‐suppressive requires extra care.MethodAmong 108 lung cancer patients who had been hospitalized during the COVID‐19 pandemic, 18 with respiratory symptoms were evaluated retrospectively.ResultsThe patients’ median age was 64 ± 9.4 with a male predominance (male n = 16, female n = 2). Thirteen had non‐small cell lung cancer (NSCLC), and 5 had small cell lung cancer (SCLC). Nine (50%) patients were receiving chemotherapy. The most common symptom was shortness of breath (n = 14, 77.8%), followed by fever (n = 10, 55.6%). The findings confirmed on computed thorax tomography (CTT) were as follows: consolidation (n = 8, 44.4%), ground glass opacities (n = 8, 44.4%) and thoracic tumour/mediastinal‐hilar lymphadenopathy (n = 3, 16.7%). Hypoxia was seen in 11 patients (61.1%), twelve patients had an elevated LDH (median = 302 ± 197) and lymphopenia (median = 1055 ± 648) and 5 (27.7%) were highly suspected of having contracted COVID‐19. None of their nasopharyngeal swaps was positive. Two of these 5 patients received COVID‐19 specific treatment even though they thrice had negative reverse transcription polymerase chain reaction (RT‐PCR) results. The two patients responded well to both clinical and radiological treatments. For one case with SCLC receiving immunotherapy, methylprednisolone was initiated for radiation pneumonitis after excluding COVID‐19.ConclusionIn line with a country's health policies and the adequacy of its health system, the necessity of a multidisciplinary approach in the management and treatment of complications in patients with lung cancer has become even more important during the COVID‐19 pandemic.