Does a prior COVID-19 infection affect lung dynamics during thoracic anesthesia?

SARS-CoV-2 has infected more than 776 million people worldwide, raising concerns about its impact on patients with lung cancer, the most common cancer in men and the second most common cancer in women. Previous studies have suggested that COVID-19 may worsen lung dysfunction in patients undergoing surgery and that the coexistence of COVID-19 and lung cancer increases the risk of complications and mortality. It has been recommended that surgery be delayed after COVID-19 infection to reduce postoperative risk. This study examined the effects of prior COVID-19 infection on respiratory mechanics in patients undergoing thoracic surgery for lung cancer. A retrospective study of 110 patients who underwent thoracic surgery at Ankara University Ibni Sina Hospital between 2021 and 2024 was conducted with registration number NCT07118917. Of these, 53 were positive for COVID-19. Respiratory mechanics were assessed during surgery via the mechanical power (MP) and Horowitz indices. Statistical analysis was performed via SPSS, with significance set at a p value < 0.05. The results revealed no significant differences in postoperative complications, mechanical power, or Horowitz indices between the COVID-19-positive and -negative groups. Additionally, no significant differences were found in hospital or ICU(Intensive care unit) stay length or chest removal time. Logistic regression analysis showed no significant association between the waiting interval and postoperative pulmonary complications (OR = 0.99; 95% CI, 0.98–1.01; p = 0.249). In conclusion, prior COVID-19 infection was not associated with statistically significant differences in lung dynamics or postoperative outcomes when an optimal waiting period before surgery is followed. However, careful perioperative management, including lung-protective strategies, remains essential. Further research is needed to explore the long-term effects of COVID-19 on lung function, particularly in patients needing prolonged mechanical ventilation. NCT07118917, registered on 2024-09-12.