ArticleBMC infectious diseases2025
Long-term impact of COVID-19 in patients with lung cancer receiving immune checkpoint inhibitors: a multicenter cohort study during Omicron pandemic.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe long-term impact of COVID-19 on cancer patients receiving immune checkpoint inhibitors (ICIs) remained unknown. This study aimed to investigate the association between COVID-19 and long-term outcomes in ICIs-treated lung cancer patients.
methodsThree hundred eighty-one patients with advanced lung cancer who were treated with ICIs were enrolled and followed for at least 6 months in 10 medical centers in China during Omicron pandemic. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Cox model with time-dependent covariate and landmark analysis were used.
resultsThe multivariable analysis showed that patients with COVID-19 had significantly worse OS (HR: 2.59 [1.58-4.26], P < 0.001) and PFS (HR: 1.55 [1.02-2.35], P < 0.001). In landmark analyses, COVID-19 that occurred within 3 months after initiation of ICIs was found to be associated with shorter OS (HR: 3.40 [1.70-6.77], P = 0.001) and PFS (HR: 3.40 [1.70-6.77], P = 0.02). In subgroup analysis, both mild and severe COVID-19 were associated with shorter OS (mild, HR: 2.39 [1.33-4.29], P = 0.004; severe, HR 4.46 [2.39-8.33], P < 0.002) and PFS (mild, HR 1.71 [1.05-2.78], P = 0.03; severe, HR 3.32 [1.97-5.60], P < 0.002). Additionally, there were no significant differences in OS or PFS among patients with varying treatment delays.
conclusionsCOVID-19 had a negative impact on the long-term outcomes of patients with lung cancer who received ICIs, particularly if the infection occurred during the first 3 months of ICIs treatment. These findings are crucial for addressing the COVID-19 epidemic and other respiratory infectious diseases.
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