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.
Highlights
Lung cancer is a serious threat to human health, having the highest morbidity and mortality rates among cancers worldwide [1]
In the pre-epidemic group, 91 (58.3%) and 65 (41.7%) patients were diagnosed from physical examination and symptoms, respectively
A recent report on the impact of COVID-19 on cancer diagnosis showed that the number of newly registered cancer patients in the Dutch National Cancer Registry decreased by about 25% in the period from March to May 2020 compared with the same period in the past [12]
Summary
Lung cancer is a serious threat to human health, having the highest morbidity and mortality rates among cancers worldwide [1]. Adequate management of patients with lung cancer during the COVID-19 pandemic is important in the context of its long-term persistence [5, 6]. As high-risk areas, hospitals in China initiated special control measures to prevent nosocomial infections during the COVID-19 pandemic. The prevention and control measures employed in the hospitals have had positive effects in controlling the spread of the virus, they have affected the treatments for other conditions, including lung cancer. The association between COVID-19 and the diagnosis and clinical characteristics of lung cancer is unclear. This study aimed to identify and analyse any influences of COVID-19 on the clinical characteristics and diagnosis of newly confirmed lung cancer patients during the pandemic in our hospital
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