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PS63. Risk of COVID-19 Infection During Lung Cancer Treatment in the First Year of the Pandemic in the U.S.

May 6, 2023

103rd Annual Meeting, the Los Angeles Convention Center, Los Angeles, CA, USA
Los Angeles Convention Center, Outside of Room 408
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To evaluate the likelihood of developing a COVID-19 infection while undergoing treatment for lung cancer during the first year of the pandemic, as well as the additional risk of death associated with COVID-19 infection in this time period.

Patients diagnosed with non-small cell lung cancer (NSCLC) in 2020 were evaluated in the National Cancer Database (NCDB). Three data fields were added in 2020 by the NCDB: 1) was a COVID-19 test performed, 2) did the patient test positive for COVID-19, and 3) the date of the patient's first positive COVID-19 test. The 90-day survival (from treatment initiation) for patients with a first COVID-19 diagnosis within 90 days following treatment initiation was assessed by calculating relative risks and by using Kaplan-Meier analysis among 1:2 propensity score-matched cohorts.

A total of 80,471 patients underwent treatment for NSCLC in 2020, of which 37,599 (46.7%) were tested for COVID-19. Overall, 525 (1.5%) patients tested positive for COVID-19 within the first 90 days of initiating treatment. This included 0.9% (n=89) of surgically managed patients, 1.5% (n=269) of patients who received chemotherapy, and 1.6% (n=327) of patients who received radiotherapy. The relative risk of 90-day mortality (COVID-19 positive vs. negative) was 4.75 (95% CI: 2.66-8.46) after surgery, 2.55 (95% CI: 2.03-3.19) after chemotherapy, and 2.25 (95% CI: 1.86-2.72) after radiotherapy. For each treatment modality, Kaplan-Meier analysis demonstrated significantly worse 90-day survival among patients testing positive for COVID-19 (Figure).

In the first year of the COVID-19 pandemic, the risk of developing a COVID-19 infection while undergoing surgery, chemotherapy, and radiotherapy for non-small cell lung cancer appeared to be low. However, a COVID-19 infection during the time frame in which patients were undergoing treatment was associated with increased 90-day mortality, particularly in surgically managed patients.

Peter Zhan (1), Maureen E. Canavan (2), Brooks Udelsman (1), Attila Nemeth (3), Sora Ely (1), Daniel Boffa (1), (1) Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT, (2) Cancer Outcomes Public Policy and Effectiveness Research Center, Yale University School of Medicine, New Haven, CT, (3) Department of Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Tübingen, NA

Peter Zhan

Poster Presenter

Peter Zhan, MD is currently a general surgery resident at Yale. He is originally from the San Francisco Bay Area and holds a B.S. in Molecular Biophysics and Biochemistry from Yale College in New Haven. He completed his medical degree at Northwestern University Feinberg School of Medicine in Chicago. He has been working with Dr. Daniel Boffa, Division Chief of Thoracic Surgery at Yale, to investigate clinical outcomes in thoracic cancer patients.

Specialties: General Thoracic, Thoracic, Perioperative Management/Critical Care, Procedures, Anatomy and Conditions, Lung--Cancer, Treatment/Procedure/Operation/Surgery, Lung--Cancer