Safety and feasibility of thoracic malignancy surgery during the COVID-19 pandemic

Ann Thorac Surg. 2020 Dec 14;S0003-4975(20)32115-9. doi: 10.1016/j.athoracsur.2020.12.001. Online ahead of print.

Abstract

Background: The COVID-19 pandemic has decreased surgical activity, particularly in the field of oncology, due to the suspicion of a higher risk of COVID-19-related severe events. We aimed to investigate the feasibility and safety of thoracic cancer surgery in the most impacted European and Canadian regions during the COVID-19 pandemic.

Methods: We prospectively collected data on thoracic malignancies surgeries from January 1 to April 30, 2020. We included patients from six high-volume thoracic surgery departments: Nancy and Strasbourg (France), Freiburg (Germany), Milano and Torino (Italy), and Montreal (Canada). The centers involved in this research are all located in the most impacted regions of the countries concerned. An assessment of COVID-19-related symptoms, polymerase chain reaction (PCR)-confirmed COVID-19 infection, rates of hospital and intensive care unit admissions and deaths was performed for each patient. Every death was tested for COVID-19 by PCR.

Results: In the study period, 731 patients who underwent 734 surgical procedures were included. In the whole cohort, 9 cases (1.2%) of COVID-19 were confirmed by PCR, including 5 in-hospital contaminants. Four patients (0.5%) needed readmission for oxygen requirements. In this subgroup, two patients (0.3%) needed ICU and mechanical ventilatory support. The total number of deaths in the whole cohort was 22 (3%). A single death was related to COVID-19 (0.14%).

Conclusions: Maintaining surgical oncologic activity in the era of the COVID-19 pandemic seems safe and feasible, with very low postoperative morbi-mortality. To continue to offer the best care to non-COVID-19 patients, reports on other diseases are urgently needed.