Abstract
Background:
In contrast to the clear impact of previous lung cancer to the clinical course of the COVID-19, the impact of COVID-19 as serious infection to the development of lung cancer has not been found. We aimed to learn the risk factors for incidence of lung cancer in patients with history of the COVID-19 infection.
Methods:
We have assessed the lung CT scan of the 1215 patients with COVID-19 timely: at the time of acute lung infection; 3 months after COVID-19 infection; and 6 months after COVID-19 infection. All patients with COVID-19 were assessed by severity of the disease course: mild, moderate, and severe.
Results:
In 59 patients of 1,215 have been evaluated and confirmed the diagnosis of lung cancer (4.9%). In surviving patients with ARDS, massive and non-resolving fibrosis was leading cause for lung cancer incidence and in 32 patients of 59 the cancer was developed after surviving ARDS (P < 0.001) and all ARDS cases were severe. In non-ARDS lung cancer patients (27 of 59) lung fibrosis together with smoking history also was leading factor for development of lung cancer after COVID-19 infection compared to non-cancer patients (P < 0.01). Commonly lung cancer developed at 3 months after COVID-19 infection and this incidence was significantly higher compared to the 6 months after lung infection (OR 2.58 [0.85--6.49] 95% CI; P < 0.002). At the time of acute lung infection in lung cancer patients, lymphopenia was significantly higher compared to non- lung cancer patients (OR 3.48 [0.92–8.94] 95% CI; P < 0.001). Comorbidity as COPD was associated most commonly with lung cancer compared to patients without lung cancer (OR 6.37 [1.21–13.35] 95% CI; P < 0.001). Most common histological type of lung cancer was squamous compared to adenocarcinoma (OR 2.43 [0.67--7.28] 95% CI; P < 0.006).
Conclusions:
The incidence of lung cancer in patients with COVID-19 was most commonly associated with several risk factors including older age, male gender, lymphopenia at the time of acute lung infection, and COPD as comorbidity. Lung cancer most common was found at three months after lung infection, and most commonly incidence of lung cancer was observed in patients after surviving severe COVID-19 infection with severe ARDS in whom was developed massive and non-resolving fibrosis with history of cigarette smoking and most commonly type of the lung cancer was squamous cell lung cancer.
Get full access to this article
View all access options for this article.