Impact of coronavirus disease 2019 on the clinical course of thoracic malignancies

Background: The coronavirus disease 2019 (COVID-19) pandemic has had an enormous impact on the health care system, including the management [a1] of malignant diseases. This study aimed to evaluate the impact of the COVID-19 pandemic on the diagnosis, treatment, and prognosis of thoracic malignancies. Methods: We retrospectively reviewed patients who presented to our institute for the treatment of thoracic malignancies between March 2019 and February 2021; we compared the pre-pandemic group up to February 2020 and the pandemic group after March 2020. We set the observation period as from the initial visit to the time of death or September 2022, whichever was shorter. We defined advanced stage as incurable stage III or stage IV. Results: During the period covered, 190 patients from the pandemic group and 212 from the pre-pandemic group visited our institute. The median time from the initial visit to diagnosis was 15 days (p = 0.50) for both the pandemic and pre-pandemic groups. Sixty-eight patients (36%) in the pandemic group and 98 patients (46%) in the pre-pandemic group were in an advanced stage of the cancer (p = 0.03). Among them, 49 (72%) patients in the pandemic group and 66 (67%) patients in the pre-pandemic group received anticancer therapy (p = 0.52). Median overall survival time was 8.7 months in the pandemic group and 10.9 months in the pre-pandemic group (p = 0.45) Twenty-five patients(37%) in the pandemic group and 43 patients (44%) in the pre-pandemic group (p = 0.36) achieved more than one year survival. Conclusions: A COVID-19 pandemic could have an unfavorable impact on survival for advanced stage thoracic malignancies.