Table 1.

Lung cancer and COVID-19 rapid review study characteristics.

Author	Title	Country	Design	Participants	Setting	Outcome Measures	Summary of Findings
Gebbia et al.72	Patients with cancer and COVID-19: a WhatsApp messenger-based survey of patients’ queries, needs, fears, and actions taken	Italy	Observational study survey	446 patients 62 patients with lung cancer	Secondary care	• Requirement of visit delay by patients undergoing oral therapies or in follow-up • Delays in chemotherapy or immunotherapy administration • Queries about possible immunosuppression • Changes in lifestyle or daily activities	WhatsApp was an adequate mode of providing a rapid answer to most queries from patients with cancer in the COVID-19 pandemic
Zhang et al.73	Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China	China	Retrospective cohort study	7 patients with lung cancer	Secondary care	• ICU admission • Mechanical ventilation • Death	Cancer patients show deteriorating condition and poor outcomes from COVID-19 infection. Recommends that cancer patients receiving antitumour treatments should have vigorous screening for COVID-19 infection and avoid treatments causing immunosuppression or have their dosages decreased in case of COVID-19 coinfection
Dai et al.74	Patients with cancer appear more vulnerable to SARS-CoV-2: a multicenter study during the COVID-19 outbreak	China	Observational multicentre cohort study	105 COVID-22 patients with lung cancer	Secondary care	• ICU admission • One severe or critical symptom • Mechanical ventilation • Death	Patients with haematological cancer, lung cancer or with metastatic cancer (stage IV) had the highest frequency of severe events
Garassino et al.75	COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an International, Registry-Based, Cohort Study	Multinational	Multicentre longitudinal cohort study	200 patients 180 patients with lung cancer	Secondary care	• Demographics • Oncological history and comorbidities • COVID-19 diagnosis • Disease sequelae • Clinical outcomes	Data suggests high mortality and low admission to intensive care in patients with thoracic cancer
Ghosh et al.76	Perspective of oncology patients during COVID-19 pandemic: a prospective observational study from India	India	Observational study survey	302 patients 44 patients with Lung Cancer	Secondary care	• Willingness to continue chemotherapy during this pandemic and factors influencing the decisions	Oncology patients are more worried about disease progression than the SARS-CoV-2 and wish to continue chemotherapy during this pandemic
Rogado et al.77	COVID-19 and lung cancer: a greater fatality rate?	Spain	Retrospective cohort study	1878 medical records 17 patients with Lung Cancer	Secondary care	• Treatment outcome • Mortality • Associated risk factors	17 cases of lung cancer with COVID-19 infection were detected. Of these nine died (52.3%). Combined treatment with hydroxychloroquine and azithromycin was used in lung cancer patients, detecting only 1/6 deaths between patients under this treatment vs. others treatment, with statistical significance in the univariate and multivariate logistic regression (OR 0.04, p = 0.018)
Luo et al.50	COVID-19 in patients with lung cancer	USA	Observational multicentre cohort study	102 patients	Secondary care	• Disease severity • Mortality • Recovery • Human leucocyte antigen analysis	COVID-19 was severe in patients with lung cancer (62% hospitalised, 25% died). Determinants of COVID-19 severity were largely patient-specific features, including smoking status and chronic obstructive pulmonary disease. Cancer-specific features, including prior thoracic surgery/radiation and recent systemic therapies did not impact severity. Human leucocyte antigen supertypes were generally similar in mild or severe cases of COVID-19 compared with non-COVID-19 controls.
Sha et al.78	The impact of the COVID-19 pandemic on lung cancer patients	China	Retrospective cohort study	161 patients	Secondary care	• Response evaluation criteria in solid tumour (RECIST 1) • Delayed admission	29.4% (n = 47) patients had delayed admission during the epidemic and having to discontinue or delay their regular anticancer treatments. Of these 47 delayed patients, 33 were evaluated for tumour status using a computed tomography scan, 6 of these 33 cases (18.2%) were diagnosed as progressive disease (PD) and 5 cases did not return for visit
Calles et al.79	Outcomes of COVID-19 in patients with lung cancer treated in a tertiary hospital in Madrid	Spain	Observational, retrospective cohort single-centre study	23 patients	Secondary care	• Clinical features, • Pathology, laboratory and Radiological data • Treatment schemes	All patients had at least 1 COVID-19-related symptom; cough (48%), shortness of breath (48%), fever (39%) and low-grade fever (30%) were the most common. Time from symptoms onset to first positive SARS-CoV-2 PCR was 5.5 days (range 1–17), with 13% of cases needed from a second PCR to confirm diagnosis. There was a high variability on thoracic imaging findings, with multi-lobar pneumonia as the most commonly found pattern (74%). Main lab test abnormalities were low lymphocytes count (87%), high neutrophil-to-lymphocyte ratio (NLR) (78%) and elevated inflammatory markers: fibrinogen (91%), C-reactive protein (CRP) (87%), and d-dimer (70%)
Leclère et al.80	Maintaining surgical treatment of non-small cell lung cancer during the COVID-19 pandemic in Paris	France	Observational retrospective database study	115 patients	Secondary care	• Incidence and prognosis of COVID-19 during the first 30 days following surgery • Secondary endpoints • 30-day morbidity • 30-day mortality • Proportion of patients with complete resection on the surgical specimen • Proportion of patients with suspected COVID-19 on the pathological examination of the surgical specimen	Compared to COVID negative patients, COVID positive patients were more likely to be operated on during the first month of the pandemic (100 vs. 54%, p = 0.03) and to be on corticosteroids preoperatively (33 vs. 4%, p = 0.03). Postoperative COVID-19 was associated with an increased rate of readmission (50 vs. 5%, p = 0.004), but no difference in 30-day morbidity (for the study group: grade 2, 24%; grade 3, 7%; grade 4, 1%) or mortality (n = 1 COVID negative patient, 0.9%). Immediate oncological outcomes did not differ significantly between groups (R0 resection 99%, nodal upstaging 14%, adjuvant treatment 29%)
Zhang et al.81	COVID-19 and early-stage lung cancer both featuring ground-glass opacities: a propensity score-matched study	China	Retrospective cohort study	531 patients • 157 patients with COVID-19 • 374 patients with early lung cancer	Secondary care	• Epidemiological characteristics • Clinical characteristics • Radiological characteristics • Pathological characteristics	Lesions in COVID-19 involved more lobes and segments (median 6 vs. 1; p < 0.0001) and tended to have multiple types (67%) with patchy form (54%). In most cases, a treatment delay was requested by the patient, suggesting that lung cancer patients had more COVID‐19‐related anxiety than expected. Patients with delayed treatment received significantly more immune checkpoint inhibitor (ICI) monotherapy than patients without delayed treatment
Fu et al.82	Real-World Scenario of Patients with Lung Cancer Amid the Coronavirus Disease 2019 Pandemic in the People’s Republic of China	China	Observational multicentre self-administered survey	803 patients with lung cancer at 65 hospitals	Secondary care	• Medical demands of patients with lung cancer	Patients with lung cancer were most concerned about long waiting times for outpatient services, in-patient beds, physical examinations or operations (406; 50.6%); the possibility of infection with the novel coronavirus (359; 44.7%); and the difficulties in getting to a hospital owing to transportation problems (279; 34.7%). Patients in stages I and II revealed having less fear about disease progression (14 [18.2%] and 4 [14.8%], respectively), had lower proportions of delayed medical appointments (15 [19.5%] and 6 [22.2%], respectively) and complained less about complex treatment procedures (12 [15.6%] and 5 [18.52%], respectively). Patients in the high-infected area (345, 56.7%) complained more frequently about longer booking periods than those in the low-infected area (61, 31.3%)
Fujita et al.83	Impact of COVID-19 pandemic on lung cancer treatment scheduling	Japan	Observational retrospective study	165 patients (medical records)	Secondary care	• Delay in treatment schedule	Lung cancer treatments of 15 patients (9.1%) were delayed during the COVID‐19 pandemic
Hyland and Jim et al.84	Behavioural and psychosocial responses of people receiving treatment for advanced lung cancer during the COVID-19 pandemic: A qualitative analysis	USA	Qualitative study	15 patients	Secondary care	• Themes related to the behavioural and psychosocial responses	Six themes emerged from this qualitative study, including cancer as the primary health threat, changes in oncology practice and access to cancer care, awareness of mortality and perceptions of risk, behavioural and psychosocial responses to COVID-19, sense of loss/mourning and positive reinterpretation/greater appreciation for life
Yang et al.85	Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study	China	Retrospective, multicentre cohort	205 patients	Secondary care	• Clinical outcomes • Laboratory findings • Chest CT examinations • Treatment • Mortality	Patients with cancer and COVID-19 who were admitted to hospital had a high case-fatality rate. Unfavourable prognostic factors, including receiving chemotherapy within 4 weeks before symptom onset and male sex, might help clinicians to identify patients at high risk of fatal outcomes