Composition of patients undergoing pulmonary surgery before and after pandemic of COVID-19

Background: The object was to compare changes in patients undergoing lung surgery before and after COVID-19 outbreak, and to explore the impact of COVID-19 on lung surgery and its coping strategies. Method: A single-institution, retrospective review of patient in thoracic surgery between 2019-01-23 and 2020-01-23(group A), or patient between 2020-06-01 and 2021-06-01(group B) in our center was performed. We compared the reasons of seeking medical treatment, the general characteristics of patients, imaging features, pathological features, surgical methods and postoperative recovery. Result: Patients with pulmonary nodules screened by physical examination increased in group B (57.6% vs 46.9%, p<0.05). Female patient increased (55.2%vs 44.7%). Patient without smoking history or with family history of lung cancer increased (70.7% vs 60.7%) (10.1%vs 7.8%). Early stage lung cancer increased. Lobectomy decreased (53.4% vs 64.1%). Segmental resection increased (33.3% vs 12.7%). Patients without Postoperative complications increased (96.1%vs 85.7%). For patients with GGO, the age was younger (52vs55), the female patients increased, patient without smoking history ,tumor history ,family history of tumor increased. Early stage GGO and smaller GGO increased. Lobectomy decreased (35.2% vs 49.7%). Segmental resection increased(49.6% vs 21.2%). Patients without Postoperative complications increased (96.5% vs 87.4%) Conclusion: Since COVID-19 outbreak, more young, non-smoking, female lung cancers, more early GGOs ,none high risk patients have been detected through screening, suggesting that our current screening criteria for lung cancer may need to be revised. Higher requirements, including the selection of the timing of nodular surgery, surgical methods and nodular localization were put forward for thoracic surgeons' skills.