Narrative review of lung cancer treatment at the time of COVID-19 pandemia: pitfall and issues

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), responsible for coronavirus disease 2019 (COVID-19) pandemic, has caused disruption in cancer care and research, changing daily management approach of cancer patients, above all for those affected by lung cancer disease. Unfortunately, its length and severity beyond today is still uncertain. This emerged viral pandemic has produced severe illness to overwhelm healthcare infrastructure, with worse impact on public health system and on providers of essential community services, and needing to ration medical equipment and interventions. Several data from across the world highlighted the susceptibility of patients affected by tumors to high severe infection and mortality from COVID-19. Lung cancer patients emerged as “frail” subgroup, mainly attributable to their immunosuppression, co-existing medical conditions and underlying pulmonary compromise. So, the lung cancer care was confounded by urgent need for intervention for most patients and the competing risk of life-threatening COVID-19 infection, and also influenced by competing needs for personnel, beds and equipment for urgent COVID-19 care. Clearly, no one model of care is possible during all pandemic phases or in all medical environments. In this review we will discuss on available data and their impact on prioritizing the individual management for lung cancer patients, with aim to protect them from COVID-19.