Abstract
OBJECTIVE: This study aimed to delineate the occurrence and duration of the symptoms of coronavirus disease 2019 (COVID-19) in patients with lung cancer to provide supporting data for clinical research and epidemic prevention and control. METHODS: This prospective longitudinal study was conducted in a tertiary hospital in China, comprising 697 outpatients and inpatients with lung cancer seeking medical care between March and April 2023. The enrolled patients completed questionnaires during the visit, with subsequent follow-up by telephone at 6 months after the patients' first infection. The questionnaire covered general patient information, disease characteristics, and SARS-CoV-2 infection and vaccine status. The details of COVID-19 treatment included the diagnostic method, infection time, and lung cancer treatment for up to three months after infection. This study also investigated the symptoms and duration of COVID-19. RESULTS: Among 697 patients, 591 (84.79%) had a history of COVID-19, 165 patients (27.92%) were not vaccinated, and 339 (57.36%) received the recommended ≥ 3 doses of the COVID-19 vaccine, yielding a 72.08% overall vaccination rate. The predominant symptoms of the initial SARS-CoV-2 infection included fever (79.53%), muscle pain (49.24%), cough (48.22%), sore throat (46.02%), and fatigue (35.36%). Patients who were infected with COVID-19 after the lung cancer diagnosis and received systematic treatment exhibited significant differences in muscle pain (χ(2) = 11.808, P = 0.038), sore throat (χ(2) = 14.368, P = 0.013), nasal congestion (χ(2) = 12.934, P = 0.024), and chest tightness/pain (χ(2) = 12.218, P = 0.032). The symptom analysis indicated that the duration of symptoms was significantly longer in unvaccinated than in vaccinated patients with lung cancer experiencing a first-time COVID-19, especially for fever (χ(2) = 21.268, P = 0.001) and palpitations (χ(2) = 17.797, P = 0.007). The six-month follow-ups in this study revealed that 12.01% of patients with lung cancer experienced a second infection. Patients with lung cancer reinfected with COVID-19 exhibited fever (χ(2) = 16.780, P = 0.005), muscle pain (χ(2) = 28.489, P = 0.000), sore throat (χ(2) = 21.915, P = 0.001), rhinorrhea (χ(2) = 20.783, P = 0.002), cough (χ(2) = 19.129, P = 0.004), expectoration (χ(2) = 16.105, P = 0.013), shortness of breath (χ(2) = 26.461, P = 0.000), palpitations (χ(2) = 17.065, P = 0.004), chest tightness/pain (χ(2) = 13.108, P = 0.041), fatigue (χ(2) = 21.593, P = 0.001), reduced activity tolerance (χ(2) = 35.476, P = 0.000), headache (χ(2) = 16.003, P = 0.001), hypogeusia (χ(2) = 42.511, P = 0.000), hyposmia (χ(2) = 20.650, P = 0.002), and diarrhea (χ(2) = 9.397, P = 0.024) revealed significant differences in comparison with the first-time COVID-19 infection in patients with lung cancer. CONCLUSIONS: Our analysis suggests that COVID-19 has a high infection rate in patients with lung cancer, but the duration of different symptoms varies. Patients with a first SARS-CoV-2 diagnosis who had previously been treated for oncology experienced less severe pain-related symptoms than patients with lung cancer diagnosed after infection. COVID-19 vaccines have demonstrated protective effects by mitigating symptom severity following a second infection. Suggest that we should further explore ways to reduce the morbidity, severity, and mortality of COVID-19 while ensuring adherence to patients' standard treatment plans.