Background: Studies have shown that the incidence and severity of corona virus disease 2019 (COVID-19) in patients with lung cancer are higher than those in healthy people. At present, the main anti-tumor treatments for lung cancer include surgery, immunotherapy, chemotherapy, radiotherapy, targeted therapy and anti-angiogenesis therapy. While the effects of different anti-tumor treatments on the occurrence and severity of COVID-19 pneumonia are not uniform. Therefore, we aimed to describe clinical characteristics and antitumor therapy of patients with lung cancer and COVID-19 pneumonia, and examined risk factors for severity in this population.
Methods: From December 1, 2022 to February 15, 2023, a retrospective study was conducted in 217 patients diagnosed with COVID-19 and pathologically confirmed lung cancer in the Jinling Hospital. We collected data about patients' clinical features, antitumor treatment regimen within 6 months, and the diagnosis and treatment of COVID-19. Risk factors for occurrence and severity of COVID-19 pneumonia were identified by univariable and multivariable Logistic regression models.
Results: (1) Among the 217 patients included, 51 (23.5%) developed COVID-19 pneumonia, of which 42 (82.4%) were classified as medium and 9 (17.6%) were classified as severe; (2) Univariate and multivariate analysis revealed overweight (OR=2.405, 95%CI: 1.095-5.286) and intrapulmonary focal radiotherapy (OR=2.977, 95%CI: 1.071-8.274) are risk factors for increasing occurrence of COVID-19 pneumonia, while other therapies are not; (3) Chronic obstructive pulmonary disease (COPD) history (OR=7.600, 95%CI: 1.430-40.387) was more likely to develop severe pneumonia and anti-tumor therapies such as intrapulmonary focal radiotherapy, chemotherapy, targeted therapy and immunotherapy did not increase severity.
Conclusions: Intrapulmonary focal radiation therapy within 6 months increased the incidence of COVID-19 pneumonia, but did not increase the severity. However, there was no safety concern for chemotherapy, targeted therapy, surgery and immunotherapy.
【中文题目：不同抗肿瘤治疗方案对肺癌患者新型冠状 病毒感染后肺炎发生及严重程度的影响： 一项单中心回顾性研究】 【中文摘要：背景与目的 与健康人群相比，肺癌患者新型冠状病毒感染（corona virus disease 2019, COVID-19）的发生率及严重性会增加。目前肺癌的主要治疗方案包括手术、免疫治疗、化疗、放疗、靶向治疗以及抗血管生成治疗，不同抗肿瘤治疗方案对COVID-19的发生及严重性的影响结论尚不统一。本研究旨在探究半年内各种抗肿瘤治疗方案（化疗、靶向治疗、抗血管生成治疗、放疗、免疫治疗和外科手术）是否影响COVID-19后肺炎（以下简称新冠肺炎）的发生率及严重程度。方法 我们对2022年12月1日-2023年2月15日南京大学附属金陵医院收治的COVID-19且病理确诊为肺恶性肿瘤的217例患者进行了回顾性研究。收集患者临床特征、6个月内抗肿瘤治疗方案以及COVID-19诊断、治疗及转归的数据。通过单因素和多因素Logistic回归分析影响新冠肺炎及影响其严重性的危险因素。结果 （1）纳入的217例患者中，共51例（23.5%）发生新冠肺炎，其中临床分级为中型42例（82.4%），重型及危重型9例（17.6%）；（2）通过单因素及多因素分析发现超重（OR=2.405, 95%CI: 1.095-5.286）以及肺内病灶放疗（OR=2.977, 95%CI: 1.071-8.274）是影响新冠肺炎发生的危险因素，而全身化疗、靶向治疗以及免疫治疗并不会导致新冠肺炎发生率的增加；（3）在严重程度影响因素的分析中，除了既往有慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD）病史（OR=7.600, 95%CI: 1.430-40.387）是重症新冠肺炎的危险因素外，肺内病灶放疗、化疗、靶向治疗以及免疫治疗均不会增加其严重程度。结论 半年内行肺内病灶放疗导致肺恶性肿瘤患者新冠肺炎的发生率增加，但也并没有增加其严重性，而化疗、靶向治疗、手术和免疫治疗并未导致肺炎的发生及其严重性的增加。 】 【中文关键词：肺肿瘤；新型冠状病毒感染；抗肿瘤治疗】.
Keywords: Antitumor treatment; Corona virus disease 2019; Lung neoplasms.