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JNCI Cancer Spectr ; 5(2): pkaa102, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1101856

ABSTRACT

BACKGROUND: Cancer patients with coronavirus disease 2019 (COVID-19) have been reported to have double the case fatality rate of the general population. METHODS: A systematic search of PubMed, Embase, and Cochrane Central was done for studies on cancer patients with COVID-19. Pooled proportions were calculated for categorical variables. Odds ratio (OR) and forest plots (random-effects model) were constructed for both primary and secondary outcomes. RESULTS: This systematic review of 38 studies and meta-analysis of 181 323 patients from 26 studies included 23 736 cancer patients. Our meta-analysis shows that cancer patients with COVID-19 have a higher likelihood of death (n = 165 980, OR = 2.54, 95% confidence interval [CI] = 1.47 to 4.42), which was largely driven by mortality among patients in China. Cancer patients were more likely to be intubated. Among cancer subtypes, the mortality was highest in hematological malignancies (n = 878, OR = 2.39, 95% CI = 1.17 to 4.87) followed by lung cancer (n = 646, OR = 1.83, 95% CI = 1.00 to 3.37). There was no association between receipt of a particular type of oncologic therapy and mortality. Our study showed that cancer patients affected by COVID-19 are a decade older than the normal population and have a higher proportion of comorbidities. There was insufficient data to assess the association of COVID-19-directed therapy and survival outcomes in cancer patients. CONCLUSION: Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity. A more nuanced understanding of the interaction between cancer-directed therapies and COVID-19-directed therapies is needed. This will require uniform prospective recording of data, possibly in multi-institutional registry databases.


Subject(s)
COVID-19/complications , Databases, Factual/statistics & numerical data , Neoplasms/complications , Neoplasms/therapy , Aged , COVID-19/epidemiology , COVID-19/virology , Cerebrovascular Disorders/complications , Female , Hospital Mortality/trends , Humans , Liver Diseases/complications , Lung Diseases/complications , Male , Metabolic Diseases/complications , Middle Aged , Neoplasms/mortality , Pandemics , Renal Insufficiency, Chronic/complications , SARS-CoV-2/physiology
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