Introduction

Patients with lung cancer (LC) are susceptible to severe outcomes from COVID-19. This study evaluated disruption to care of patients with LC during the COVID-19 pandemic.

Methods

The COVID-19 and Cancer Outcomes Study (CCOS) is a prospective cohort study comprised of patients with a current or past history of hematological or solid malignancies with outpatient visits between March 2 and March 6, 2020, at two academic cancer centers in the Northeastern United States (US). Data was collected for the three months prior to the index week (baseline period) and the following three months (pandemic period).

Results

313 of 2365 patients had LC, 1578 had other solid tumors, and 474 had hematological malignancies. Patients with LC were not at increased risk of COVID-19 diagnosis compared to patients with other solid or hematological malignancies. When comparing data from the pandemic period to the baseline period, patients with LC were more likely to have a decrease in in-person visits compared to patients with other solid tumors (aOR 1.94; 95% CI, 1.46–2.58), but without an increase in telehealth visits (aOR 1.13; 95% CI 0.85–1.50). Patients with LC were more likely to experience pandemic-related treatment delays than patients with other solid tumors (aOR 1.80; 95% CI 1.13–2.80) and were more likely to experience imaging/diagnostic procedure delays than patients with other solid tumors (aOR 2.59; 95% CI, 1.46–4.47) and hematological malignancies (aOR 2.01; 95% CI, 1.02–3.93). Among patients on systemic therapy, patients with LC were also at increased risk for decreased in-person visits and increased treatment delays compared to those with other solid tumors.

Discussion

Patients with LC experienced increased cancer care disruption compared to patients with other malignancies during the early phase of the COVID-19 pandemic. Focused efforts to ensure continuity of care for this patient population are warranted.

中文翻译：

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肺癌患者的护理中断：一项 COVID-19 和癌症结果研究

介绍

肺癌 (LC) 患者容易受到 COVID-19 的严重后果。本研究评估了 COVID-19 大流行期间对 LC 患者护理的干扰。

方法

COVID-19 和癌症结果研究 (CCOS) 是一项前瞻性队列研究，由 2020 年 3 月 2 日至 3 月 6 日期间在东北部两个学术癌症中心进行门诊就诊的目前或过去有血液学或实体恶性肿瘤病史的患者组成美国（美国）。收集指数周前三个月（基线期）和随后三个月（大流行期）的数据。

结果

2365 名患者中有 313 名患有 LC，1578 名患有其他实体瘤，474 名患有血液系统恶性肿瘤。与其他实体或血液恶性肿瘤患者相比，LC 患者诊断为 COVID-19 的风险并未增加。比较大流行期间和基线期间的数据时，与其他实体瘤患者相比，LC 患者的就诊次数更有可能减少（aOR 1.94；95% CI，1.46-2.58），但没有增加远程医疗就诊（aOR 1.13；95% CI 0.85–1.50）。LC 患者比其他实体瘤患者更有可能经历与大流行相关的治疗延迟 (aOR 1.80；95% CI 1.13–2.80)，并且比其他实体瘤患者更有可能经历成像/诊断程序延迟 (aOR 2.59 ; 95% CI, 1.46–4.47) 和血液恶性肿瘤 (aOR 2.01; 95% 置信区间，1.02–3.93）。在接受全身治疗的患者中，与其他实体瘤患者相比，LC 患者就诊次数减少和治疗延迟增加的风险也增加。

讨论

在 COVID-19 大流行的早期阶段，与其他恶性肿瘤患者相比，LC 患者经历了更多的癌症治疗中断。有必要集中精力确保为这一患者群体提供持续护理。