Cancer treatment and research communications · 2026
Prognostic implications of asymptomatic COVID-19 infection in non-small-cell lung cancer patients receiving active anticancer treatment: an observational study with prospective survival follow-up.
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Wong Sum-Yi, Chan Sum-Yin, Chan Sik-Kwan, Chau Tin-Ching, Tam Yiu-Ho, Chan Jasper Fuk Woo, Ip Chun-Yat, Choi Horace Cheuk-Wai, Ng Sherry Chor-Yi, Yuen Kwok Keung, Lee Victor Ho-Fun
Аннотация
OBJECTIVE: We previously reported that non-small-cell lung cancer (NSCLC) was a significant predictor of delayed viral clearance from their COVID-19 infection during the Omicron variant attack between January and April 2022. We now evaluated the survival outcomes of these NSCLC patients with or without COVID-19 infection during this period.
METHODS: This prospective cohort study included 276 NSCLC patients recruited. Of them, 39 patients were SARS-CoV-2 positive through PCR testing, with viral load indicated by cycle threshold (ct) values. Propensity score matching was used to ensure the COVID-positive and COVID-negative groups were comparable in demographics, disease staging, and treatment modalities. Kaplan-Meier survival analysis and Cox regression were performed to evaluate overall survival and identify OS prognostic factors.
RESULTS: After a median follow up of 39.9 months from diagnosis (interquartile range 31.3-55.5), 20 died of COVID-19 and NSCLC. OS differences counting from either their NSCLC diagnosis, or the start of anticancer treatment were insignificant among various stages of NSCLC patients infected with COVID-19, but they were significant for COVID-negative patients (P = 0.050 and P = 0.009, respectively). Exploratory analysis revealed that ct value cutoff of > 34.14 correlated with a better OS (P = 0.039). Multivariable analysis identified chemotherapy (P = 0.002), immune checkpoint inhibitor (P = 0.019), and receipt of ≥ 2 doses of COVID-19 vaccines (P = 0.011) as significant prognosticators of OS, counting from the date of anticancer treatment.
CONCLUSION: Asymptomatic COVID-19 infection might compromise survival outcomes of NSCLC patients in this study. Closer attention may be needed.
METHODS: This prospective cohort study included 276 NSCLC patients recruited. Of them, 39 patients were SARS-CoV-2 positive through PCR testing, with viral load indicated by cycle threshold (ct) values. Propensity score matching was used to ensure the COVID-positive and COVID-negative groups were comparable in demographics, disease staging, and treatment modalities. Kaplan-Meier survival analysis and Cox regression were performed to evaluate overall survival and identify OS prognostic factors.
RESULTS: After a median follow up of 39.9 months from diagnosis (interquartile range 31.3-55.5), 20 died of COVID-19 and NSCLC. OS differences counting from either their NSCLC diagnosis, or the start of anticancer treatment were insignificant among various stages of NSCLC patients infected with COVID-19, but they were significant for COVID-negative patients (P = 0.050 and P = 0.009, respectively). Exploratory analysis revealed that ct value cutoff of > 34.14 correlated with a better OS (P = 0.039). Multivariable analysis identified chemotherapy (P = 0.002), immune checkpoint inhibitor (P = 0.019), and receipt of ≥ 2 doses of COVID-19 vaccines (P = 0.011) as significant prognosticators of OS, counting from the date of anticancer treatment.
CONCLUSION: Asymptomatic COVID-19 infection might compromise survival outcomes of NSCLC patients in this study. Closer attention may be needed.