Prognostic Factors and Outcomes in Advanced Stage Lung Cancer Patients with COVID-19 Omicron Variant Infection

Zhimei Zhao,1,* Xiang Han,1,* Yunhong You,1 Jiankang Zhang,2 Keke Nie,1 Youxin Ji1 1Department of Oncology, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao City, People’s Republic of China; 2Department of Medicine, Qingdao Medical College, Qingdao University, Qingdao City, People’s Republic of China*These authors contributed equally to this workCorrespondence: Keke Nie; Youxin Ji, Department of Oncology, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, 127 Si Liu South Road, Shibei District, Qingdao City, 266042, People’s Republic of China, Tel + (86)532-6866-5078, Fax + (86)532-8486-3506, Email niekekeqd@163.com; mdji001@gmail.comBackground: We study the characteristics and outcomes in lung cancer patients with COVID-19 Omicron variant infection.Methods: Hospitalized lung cancer patients with advanced-stage disease and laboratory-confirmed COVID-19 Omicron infection were included. Pneumonitis involving at least 25% of lung parenchyma on CT scans, accompanied by symptoms and oxygen saturation below 93%, were criteria for enrollment. Pneumonitis severity was graded using CTCAE v5.0. Treatment included Paxlovid, prednisolone, anticoagulation, and ventilation. Initial data, radiographic findings, and outcomes were compared. Logistic regression was employed to determine risk factors for in-hospital mortality.Results: Fifteen patients (median age: 65 years; 80.0% males) were included. 73.3% improved and were discharged, 20.0% died, and 6.7% remained intubated. Initial symptoms included cough (100.0%), fever (73.3%), and shortness of breath (53.3%). Symptoms resolved in discharged patients. Median fever duration was 3.5 days, and respiratory symptom recovery took 26 days. Three patients died due to respiratory failure from Omicron pneumonia. Lower oxygen saturation, reduced lymphocyte/neutrophil ratio on day 7, and diffuse bilateral lung lesions were poor prognostic factors.Conclusion: This study underscores the importance of prompt intervention and early diagnosis for lung cancer patients infected with the COVID-19 Omicron variant. Lower oxygen saturation, decreased lymphocyte/neutrophil ratio on day 7, and diffuse lung lesions on CT scans were associated with worse outcomes. Clinicians should prioritize timely and comprehensive management to improve survival rates in this population.Keywords: COVID-19 omicronvariant, lung cancer, oxygen saturation, lymphocyte and neutrophils ratio, chest CT scan