Our Summary

This study looked at how COVID-19 impacted patients who had undergone lung surgery in Northern Italy, an area heavily affected by the pandemic. The researchers analyzed data from 107 patients who had lung surgery between December 2019 and March 2020. Out of these, 12 patients developed COVID-19 and 6 of them (50%) died due to complications from the virus. Only one patient (1%) in the non-COVID group died due to non-COVID related issues.

They found that the average time from surgery to the first symptoms of COVID-19 was around 48 days. Factors like the patient’s lung function, length of surgery, smoking history, Body Mass Index (BMI) and the number of lung segments removed during surgery were associated with a higher risk of getting COVID-19. These same factors, along with the patient’s overall health (measured by the Charlson Comorbidity Index or CCI), were linked to a higher risk of death.

The study suggests that patients who have undergone lung surgery and then develop COVID-19 are at a higher risk of severe respiratory complications and death. They also note that the symptoms of the virus might be subtle at first, leading to a delay in diagnosis. To reduce these risks, they recommend closely monitoring patients for symptoms and isolating them during recovery. They also advise healthcare providers to be aware of the greater risk of COVID-19 and death in patients with poor lung function, a high BMI, a smoking history or a long surgery time.

FAQs

  1. What factors were found to be associated with a higher risk of getting COVID-19 in patients who had undergone lung surgery?
  2. What is the average time from lung surgery to the first symptoms of COVID-19?
  3. What are the recommendations for healthcare providers to reduce the risk of COVID-19 in patients who have undergone lung surgery?

Doctor’s Tip

Therefore, a helpful tip a doctor might tell a patient about lung resection is to closely monitor for any symptoms of COVID-19, especially in the weeks following surgery. It is important to isolate yourself if you develop any symptoms and seek medical attention promptly. Additionally, maintaining a healthy lifestyle, including quitting smoking and maintaining a healthy weight, can help reduce the risk of complications after lung surgery. Regular follow-up visits with your healthcare provider are also crucial to monitor your recovery and catch any potential issues early on.

Suitable For

Patients who are typically recommended for lung resection are those with early-stage lung cancer, certain types of benign tumors, lung infections, or lung diseases such as emphysema or severe chronic obstructive pulmonary disease (COPD). Additionally, patients with lung nodules that are suspicious for cancer or those with localized lung metastases from other cancers may also be candidates for lung resection. Patients who are generally in good health and have adequate lung function are better candidates for lung resection surgery.

Timeline

  • Before lung resection: Patients undergo a series of pre-operative tests and evaluations to determine their eligibility for surgery. This may include imaging tests, pulmonary function tests, and blood work. They may also meet with various healthcare providers, such as surgeons, anesthesiologists, and respiratory therapists, to discuss the procedure and recovery process.

  • Day of surgery: The patient is admitted to the hospital and undergoes the lung resection procedure under general anesthesia. The surgery can involve removing a portion of the lung (lobectomy) or the entire lung (pneumonectomy), depending on the extent of the disease.

  • Immediately post-op: The patient is transferred to the recovery room where they are closely monitored for any complications, such as bleeding, infection, or respiratory issues. Pain management and respiratory therapy are initiated to help with recovery.

  • Hospital stay: The patient typically stays in the hospital for several days to a week, depending on the extent of the surgery and their overall health. During this time, they receive physical therapy, respiratory therapy, and pain management to aid in their recovery.

  • After discharge: The patient is discharged from the hospital with instructions on wound care, pain management, and activity restrictions. They are scheduled for follow-up appointments with their healthcare provider to monitor their recovery progress and address any concerns.

  • After lung resection: The patient may experience shortness of breath, chest pain, fatigue, and changes in lung function as they continue to recover from the surgery. It can take several weeks to months for the patient to fully recover and regain their normal lung function.

  • Post-COVID-19 diagnosis: If the patient develops COVID-19 after lung surgery, they may experience symptoms such as fever, cough, shortness of breath, and fatigue. The risk of severe complications and death is higher in these patients, especially if they have underlying risk factors such as poor lung function, a high BMI, a smoking history, or a long surgery time.

Overall, the recovery process after lung resection can be challenging, especially if complications such as COVID-19 arise. Close monitoring and follow-up care are essential to ensure the best possible outcome for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung resection in light of this study include:

  1. What measures will be in place to monitor me for symptoms of COVID-19 after my lung surgery?
  2. How can I reduce my risk of developing COVID-19 post-surgery?
  3. Will I be isolated during my recovery to prevent potential exposure to the virus?
  4. How will my lung function, smoking history, BMI, and other factors affect my risk of COVID-19 and death post-surgery?
  5. What steps will be taken to ensure my overall health is optimized during my recovery period?
  6. What signs and symptoms of COVID-19 should I be aware of, and when should I seek medical attention if I suspect I have contracted the virus?
  7. Will I need additional monitoring or testing due to the increased risks associated with COVID-19 post-lung surgery?
  8. How will my care plan be adjusted to account for the higher risk of respiratory complications and death if I were to contract COVID-19?
  9. Are there any specific precautions or guidelines I should follow to reduce my risk of COVID-19 post-surgery?
  10. How will my post-operative care be tailored to minimize the impact of COVID-19 on my recovery?

Reference

Authors: Scarci M, Raveglia F, Bortolotti L, Benvenuti M, Merlo L, Petrella L, Cardillo G, Rocco G. Journal: Semin Thorac Cardiovasc Surg. 2022 Summer;34(2):726-732. doi: 10.1053/j.semtcvs.2021.03.038. Epub 2021 May 11. PMID: 33989754