Abstract
BACKGROUND: 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. METHODS: 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). RESULTS: 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) vs. 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]. CONCLUSIONS: 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.