Lung cancer in the era of COVID-19

In March 2020, coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization. More than 756 million cases have been diagnosed with COVID-19, causing more than 6.8 million related deaths worldwide. In the last 3years, the severe acute respiratory syndrome coronavirus has changed the preoperative and postoperative management of thoracic surgery patients as well as many other surgical specialties. Older patients or patients with relevant chronic comorbidities such as cardiovascular disease, chronic respiratory disease, diabetes, or cancer are considered high-risk patients with an increased risk of mortality after COVID-19 infection. Indeed, oncological patients treated with systemic therapy or surgical operations tend to be more susceptible to infections due to an immunosuppressed state. Lung cancer patients are at an increased risk of COVID-19 infection, which can quickly lead to severe complications compared to nononcological patients. Unfortunately, especially during the first wave, COVID-19 had a very negative effect, significantly delaying lung cancer treatment. Considering the risks and benefits of treating lung cancer when it is still in a resectable stage, every hospital and department are responsible for taking every measure to protect all medical staff and other patients to limit the risk of the spread of infection. Moreover, based on the studies reported in this review and our experience, surgical resections can be safely performed with a minimally invasive approach and the enhanced recovery after surgery protocol can help with an early discharge and a decreased risk of contracting COVID-19. Thoracic oncology activity is safe and feasible.