Does immune checkpoint inhibitor increase the risks of poor outcomes in COVID-19-infected cancer patients? A systematic review and meta-analysis.
Cancer Immunol Immunother
; 71(2): 373-386, 2022 Feb.
Article
in English
| MEDLINE | ID: covidwho-1281266
ABSTRACT
BACKGROUND:
The association between immune checkpoint inhibitor (ICI) and outcomes of cancer patients with coronavirus disease 2019 (COVID-19) infection has yet to be systematically evaluated. This meta-analysis aims to investigate the effects of ICI treatment on COVID-19 prognosis, including mortality, severity, and any other prognosis-related outcomes.METHODS:
Eligible studies published up to 27 February 2021 were included and assessed for risk of bias using the Quality in Prognosis Studies tool. A random-effects meta-analysis was conducted to estimate the pooled effect size along with its 95% confidence intervals. The quality of body evidence was evaluated using the modified Grading of Recommendations Assessment, Development, and Evaluation framework.RESULTS:
Eleven studies involving a total of 2826 COVID-19-infected cancer patients were included in the systematic review. We discovered a moderate-to-high quality of evidence that ICI was not associated with a higher mortality risk, while the other outcomes yielded a very low-to-low-evidence quality. Although our findings indicated that ICI did not result in a higher risk of severity and hospitalization, further evidence is required to confirm our findings. In addition, we discovered that prior exposure to chemoimmunotherapy may be linked with a higher risk of COVID-19 severity (OR 8.19 [95% CI 2.67-25.08]; I2 = 0%), albeit with small sample size.CONCLUSION:
Our findings indicated that ICI treatment should not be adjourned nor terminated during the current pandemic. Rather, COVID-19 vigilance should be increased in such patients. Further studies with larger cohorts and higher quality of evidence are required to substantiate our findings. TRIAL REGISTRATION NUMBER This project has been prospectively registered at PROSPERO (registration ID CRD42020202142) on 4 August 2020.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Immune Checkpoint Inhibitors
/
SARS-CoV-2
/
COVID-19
/
Immunotherapy
/
Neoplasms
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Cancer Immunol Immunother
Journal subject:
Allergy and Immunology
/
Neoplasms
/
Therapeutics
Year:
2022
Document Type:
Article
Affiliation country:
S00262-021-02990-9
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