Niu Zhenyi, Zhu Feng, Cao Yuqin, Luo Congcong, Liu Dan, Wang Chunping, Qiu Zhenbin, Peng Lishan, Du Mingyuan, Jin Runsen, Yan Yan, Dong Dong, Jing Hui, Wang Xiaofeng, Guo Wei, Guo Zengya, Li Chengqiang, Han Dingpei, Zhang Yajie, Xiang Jie, Du Hailei, Chen Kai, Yin Zhengxin, Yang Jie, Zhong Wenzhao, Zhou Yongxin, Wang Mingsong, Ma Dongchun, Li Hecheng
Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Thoracic Surgery, Anhui Chest Hospital, Hefei, China.
Transl Lung Cancer Res. 2025 May 30;14(5):1677-1687. doi: 10.21037/tlcr-2024-1276. Epub 2025 May 28.
Previous studies found that preoperative coronavirus disease 2019 (COVID-19) was associated with higher risk of postoperative complications. A seven-to-eight week delay of surgery was recommended for patients with newly diagnosed COVID-19. However, given the widespread vaccination and less virulent variant, the timing of surgery after COVID-19 requires further evaluation. This study was conducted to investigate the impact of COVID-19 on early-stage lung cancer patients undergoing surgery.
We conducted this prospective cohort study of COVID-19 lung surgery (COVIDLungSurg) in five hospitals in China between January 2023 and April 2024. Early-stage lung cancer patients who underwent surgery were included in this study. The primary outcome was the rate of postoperative complication within the first postoperative 30 days. The secondary outcomes included total length of hospital stay, postoperative stay, and 30-day mortality. Adjusted analyses were performed using propensity score matching and logistic regression models. This study was registered at ClinicalTrials.gov (NCT05684549).
Of the 1,734 patients included in our study, 1,496 had preoperative COVID-19. A total of 1,538 patients were fully vaccinated against COVID-19. The rate of postoperative complication was 9.5% (165/1,734) in all the included patients, with no significant difference in patients with and without history of COVID-19 [9.2% (137/1,496) 11.8% (28/238), P=0.20]. Among patients with preoperative COVID-19, time since COVID-19 to surgery did not show any association with postoperative complications in the multivariable logistic regression model [odds ratio, 1.00; 95% confidence interval (CI): 0.99-1.01; P=0.41].
In the Omicron predominant era, preoperative COVID-19 was not associated with higher risk of postoperative complications in early-stage lung cancer patients. The time between COVID-19 infection and surgery was not associated with postoperative complications.
既往研究发现，术前感染2019冠状病毒病（COVID-19）与术后并发症风险较高相关。对于新诊断为COVID-19的患者，建议手术延迟7至8周。然而，鉴于广泛接种疫苗以及病毒变异株毒性降低，COVID-19感染后的手术时机需要进一步评估。本研究旨在调查COVID-19对接受手术的早期肺癌患者的影响。
我们于2023年1月至2024年4月在中国的五家医院开展了这项COVID-19肺部手术（COVIDLungSurg）前瞻性队列研究。本研究纳入接受手术的早期肺癌患者。主要结局为术后30天内的术后并发症发生率。次要结局包括住院总时长、术后住院时长和30天死亡率。使用倾向评分匹配和逻辑回归模型进行校正分析。本研究已在ClinicalTrials.gov注册（NCT05684549）。
在我们纳入的1734例患者中，1496例术前感染COVID-19。共有1538例患者完成了COVID-19疫苗全程接种。所有纳入患者的术后并发症发生率为9.5%（165/1734），有COVID-19病史和无COVID-19病史的患者之间无显著差异[9.2%（137/1496）对11.8%（28/238），P = 0.20]。在术前感染COVID-19的患者中，COVID-19感染至手术的时间在多变量逻辑回归模型中与术后并发症无任何关联[比值比，1.00；95%置信区间（CI）：0.99 - 1.01；P = 0.41]。
在奥密克戎毒株占主导的时代，术前感染COVID-19与早期肺癌患者术后并发症风险较高无关。COVID-19感染与手术之间的时间间隔与术后并发症无关。
