Sex-dependent features of primary non-small cell lung cancer course in patients with previous COVID-19.

Abstract

e20044 Background: According to global statistics, women generally experience a milder response to COVID-19 than men, and moderate relative lymphocytosis, as opposed to relative lymphopenia, is considered a favorable prognostic indicator for this disease. However, the specific features of the malignant process in patients with non-small cell lung cancer (NSCLC) of both sexes who have recovered from COVID-19 hasn´t been sufficiently studied. The aim of the research was to investigate the characteristics of the course of primary NSCLC in patients of different sexes who had COVID-19. Methods: Conventional clinical and laboratory indicators were studied in patients with stage I-III non-small cell lung cancer, men and women aged 36-75 years. The main groups consisted of 32 men and 16 women whose COVID-19 was confirmed by real-time PCR 2-9 months before hospitalization. Control groups involved of 27 men and 16 women of the same age. Cases of NSCLC progression and mortality during the first year after surgery and chemoradiation therapy were recording. The Mann-Whitney U test and Student's t-test were used in the statistical analysis of the results. Results: In almost all patients in the main groups, tumors were detected during chest X-ray examination related to COVID-19 diagnosis. In men with previous COVID-19, contradictory changes were noted: a 2.7-fold increase (p < 0.05) in the incidence of early-stage NSCLC (st. IA, B) with a simultaneous trend towards an increase in the incidence of metastasis and mortality within a year after in-hospital treatment compared with the control group (p < 0.1). Besides, in men who died within the first year after the end of antitumor treatment, the relative lymphocyte counts before the treatment corresponded to the upper limit of normal or moderate lymphocytosis (28-45%) 4 times more often than in those who died in the control group (who more often had lymphopenia, p < 0.01). Women with previous COVID-19 showed clear signs of worsening disease curse and reduced treatment effectiveness (p < 0.05-0.01) with tumor prevalence similar to that observed in the control group. No association between 1-year survival and relative lymphocyte blood count before treatment, as observed in men, was found in women. Conclusions: The obtained results indicate a significant and sex-depended impact of previous COVID-19 on the course of NSCLC. In women, an increase of the malignant process severity and a decrease in treatment effectiveness were observed. In men, a sharp increase in the incidence of NSCLC in the early stages may indicate the possibility of COVID-19-induced tumor process in the lungs. The combination of a normal or moderately elevated relative blood lymphocyte count before treatment with subsequent unfavorable NSCLC dynamics may be due to changes in the functional state of lymphocytes and loss of diagnostic value of this indicator in men under the influence of COVID-19.