Abstract
Simple SummaryFew studies have investigated the link between SARS-CoV-2 and health restrictions and its effects on the health of lung cancer (LC) patients. This study aimed to assess the impact of SARS-CoV-2 on activity volume, postoperative complications and in-hospital mortality (IHM) for LC resections in 2020 at the national level in France. Our study shows a decrease in the volume of LC resections, especially during the first lockdown. We also show that only 0.43% of patients hospitalized for LC surgery during 2020 developed a SARS-CoV-2 infection, but this low rate is counterbalanced by a high IHM (21%) in these 51 patients. Our findings suggest that, even if the IHM is high, LC surgery is feasible during a pandemic provided that the general guidance protocols edited by the surgical societies are respected. Therefore, this study provides further arguments to encourage teams to test for COVID-19 prior to surgery and patients to be vaccinated.Few studies have investigated the link between SARS-CoV-2 and health restrictions and its effects on the health of lung cancer (LC) patients. The aim of this study was to assess the impact of the SARS-CoV-2 epidemic on surgical activity volume, postoperative complications and in-hospital mortality (IHM) for LC resections in France. All data for adult patients who underwent pulmonary resection for LC in France in 2020, collected from the national administrative database, were compared to 2018–2019. The effect of SARS-CoV-2 on the risk of IHM and severe complications within 30 days among LC surgery patients was examined using a logistic regression analysis adjusted for age, sex, comorbidities and type of resection. There was a slight decrease in the volume of LC resections in 2020 (n = 11,634), as compared to 2018 (n = 12,153) and 2019 (n = 12,227), with a noticeable decrease in April 2020 (the peak of the first wave of epidemic in France). We found that SARS-CoV-2 (0.43% of 2020 resections) was associated with IHM and severe complications, with, respectively, a sevenfold (aOR = 7.17 (3.30–15.55)) and almost a fivefold (aOR = 4.76 (2.31–9.80)) increase in risk. Our study suggests that LC surgery is feasible even during a pandemic, provided that general guidance protocols edited by the surgical societies are respected.
Highlights
With an estimated 2.2 million new cases in 2020 and 1.8 million deaths, lung cancer (LC) remains the leading cause of death by cancer worldwide [1]
We found few results regarding SARS-CoV-2 infection during hospitalization for LC surgery, but we are well aware that surgical inpatients were highly selected to ensure that they were free of COVID-19
Our study in a large nationwide cohort of more than 36,000 patients confirms that the SARS-CoV-2 epidemic impacted surgical activity for LC in France and resulted in a large decrease in the volume of LC resections during the first lockdown
Summary
With an estimated 2.2 million new cases in 2020 and 1.8 million deaths, lung cancer (LC) remains the leading cause of death by cancer worldwide [1]. For early stage and locally advanced LC, surgical resection remains the standard of care that provides the highest overall survival [2]. SARS-CoV-2 disease 2019 (SARS-CoV-2), emerged as a new infectious disease at the end of 2019 and spread quickly worldwide. Lockdowns and restrictions policies of various temporal and geographical intensities were implemented all around the world in order to control the pandemic. In France, the first SARS-CoV-2 wave started on 23 February 2020, leading to an initial two-month lockdown (from 17 March to 11 May 2020, with an epidemic peak in mid-April 2020). A second and less stringent one-month lockdown was implemented from
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