key: cord-0828399-2fmqbcrr authors: Bai, Jie; Chu, Hongling; Ma, Shaohua; Ge, Qinggang title: Clinical features and prognosis of patients with COVID‐19 after lung surgery: A retrospective clinical study date: 2021-02-19 journal: Asia Pac J Clin Oncol DOI: 10.1111/ajco.13517 sha: b21af667ca9366e5f452dcc80ab727fffda9e7bd doc_id: 828399 cord_uid: 2fmqbcrr AIM: To evaluate whether the history of lung surgery in patients was associated with poor prognosis of coronavirus disease 2019 (COVID‐19). METHODS: Clinical data of patients with COVID‐19 in a single‐center were retrospectively analyzed. Patients with and without lung surgery were matched in 1:4 ratio to compare the differences in clinical characteristics, laboratory results, computed tomography findings, treatment regimens, and prognosis between them. RESULTS: Four patients had a history of lung surgery. The time from surgery to COVID‐19 onset ranged from 3 to 10 days, with a median of 6.75 days. The mortality rate in the surgical group was higher than that in the nonsurgical group (25.0% vs. 6.3%). CONCLUSION: Patients contracting COVID‐19 after lung surgery presented a higher death rate; hence, it is necessary to omit lung surgery in patients with active COVID‐19 infection. On March 11, 2020, the World Health Organization (WHO) declared the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak as a pandemic. 1 Patients infected with SARS-CoV-2 may develop coronavirus disease 2019 (COVID- 19) , and about 15.9-29% of them develop acute respiratory distress syndrome (ARDS) in a short period of time characterized by respiratory distress, hypoxemia, shock, or other organ failure, and even respiratory failure. [2] [3] [4] After lung surgery, patients inevitably suffer from lung function loss that cannot be restored to normal levels for a long time. [5] [6] [7] Commonly, most patients undergo lung surgery for lung cancer. Cancer patients are susceptible to SARS-CoV-2 and have worse prognosis than the general population. 8 The clinical features and prognosis of COVID-19 in this particular population have been mentioned only in a few articles. [9] [10] [11] We summarized the clinical features and prognosis of patients with COVID-19 after lung surgery at a single center. A retrospective analysis was performed in the isolation critical care The mean age of the four patients with a history of pulmonary surgery was 58.50 ± 2.38 years, and the male to female ratio was 1:1. The comparison of demographic information between the two groups is shown in We compared the laboratory indexes of the two groups ( Figure 3 ). Due to the limitation of sample size, we did not conduct statistical analysis. However, we still find that albumin, hemoglobin, lymphocytes, IL-6, and ferritin were lower in the surgery group. ing surgery. 16 Peng et al 10 reported that the number of pulmonary segmentations greater than or equal to five was found to be associated with death by COVID-19. In this study, all patients had more than three lung segments removed, and developed COVID-19 symptoms within 10 days after surgery. Although we did not confirm the lung function level of the patients by pulmonary function examination, it was predicted that the lung function level of the surgical group was lower than that of the normal population, which could affect the prognosis. The decrease in immune function after surgery can be evaluated by the decrease in lymphocytes and increase in inflammatory factors. Lymphocytosis often occurs immediately after lung surgery and is associated with postoperative pneumonia. 17 Ogawa et al. found that it takes 2 weeks for peripheral blood lymphocyte function to recover after surgery. 18 Patients contracting COVID-19 after lung surgery presented a higher death rate; hence, it is necessary to omit lung surgery in patients with active COVID-19 infection. This was a single-center retrospective study with a small sample size, and the results need to be verified by a large sample size study. Qinggang Ge and Shaohua Ma participated in the design of the study. Jie Bai contributed to the collection, analysis, and interpretation of data. Hongling Chu performed the statistical analysis. After publication, we can provide the data to others with the permission of the corresponding author. A proposal with detailed description of study objectives and statistical analysis plan will be needed for evaluation of the reasonability of requests. The corresponding authors have the right to decide whether to share the data or not based on the research objectives and plan provided. All authors declare no conflict of interest. This study was approved by the ethics committee of Peking University Third Hospital (IRB00006761-M2020060). 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