Fate of Pneumonectomy Patients During Covid-19 Pandemic

ABSTRACT

Introduction: The best treatment modality for lung cancer patients relies on survival estimates to weigh risks and benefits of treatments. However, patients who had pneumonectomy may have inherent oncologic or physiologic survival challanges. We aimed to analyzed the physiologic and survivability consequences of COVID-19 in these patients. Methods: A total of 111 of 898 patients(12.3%) who underwent resection in our clinic between 2001-2021 underwent pneumonectomy. Data of 70 patients were completed and the remaining 41 patients were excluded from the study for various reasons. The patients' survival, daily physical activities, comparison of preoperative and postoperative physical activity, and the general condition of those who had COVID-19 were questioned. Results: Sixty-seven patients were male (95.7%), three patients were female (4.3%). Forty patients (57.14%) had left pneumonectomy whereas 30 patients (42.85%) had right pneumonectomy. While 26 people (37.1%) were alive, 44 patients (62.9%) died. Four patients were suffered from COVID-19 infection and two of them died. Mortality was 50.0% whereas 1 (3.8%) and 2 (7.7%) patients had had extremely poorer and poorer physical activity compared to those of before pneumonectomy respectively, 9 patients (34.6%), 10 (38.5%) and 4 (15.4%) had same, better and extremely better physical activity compared to those of prior to pneumonectomy respectively. Estimated survival of all patients was 106 months (at the (95% confidence interval [CI]58.69-153.30 months). The median survival of patients with right pneumonectomy was 103 months (95% CI56.0-150.0 months) whereas it was 110 months (95% CI45.5-174.5 months) in patients who had left pneumonectomy (p=0.859). Conclusions: The mortality due to Covid-19 was very high following pneumonectomy although the prevalence of COVID-19 seemed low in those patients. The physical activity was found to be worsened in small fraction of patients after pneumonectomy. Pneumonectomy seems safe and not debilitating in select patients even in Covid-19 era. [Formula presented] [Formula presented] Keywords Covid-19, Pneumonectomy, Quality of Life