Impact of anti-cancer therapy on disease severity and mortality in cancer patients with COVID-19: a systematic review and meta-analysis.

Background: Cancer patients are more vulnerable to Coronavirus disease-2019 (COVID-19) and have a higher risk of adverse outcomes than the general population. Therefore, it is necessary to evaluate whether anti-cancer therapies such as surgery, chemotherapy, immunotherapy, and targeted therapy will increase the severity and mortality of cancer patients with COVID-19.Methods: Relevant articles were retrieved from PubMed, Embase, Web of Science, Cochrane Library and China National Knowledge Infrastructure (CNKI). The search time was from December 1, 2019 to January 23, 2021. Meta-analysis was conducted using Revman 5.3 statistical software.Results: A total of 26 studies were included in this meta-analysis, involving 5571 cancer patients infected with SARS-CoV-2. Meta-analysis showed that surgery, chemotherapy, immunotherapy and targeted therapy were not associated with disease severity or mortality (107/688, OR =1.30, 95% CI[0.79, 2.13], P =0.30; 1956/2674, OR =1.27, 95% CI [0.95, 1.69], P =0.10; 342/1455, OR =1.20, 95% CI [0.90, 1.61], P =0.21; 503/1378, OR =0.92, 95% CI [0.72, 1.19], P =0.54, respectively).Conclusion: In cancer patients with COVID-19, anti-cancer therapy had no adverse effect on disease severity or mortality. Further research is necessary to determine the complex interrelationship between anti-cancer therapy, particularly chemotherapy, and COVID-19.

The Efficacy of Heat-Clearing (Qingre) and Detoxifying (Jiedu) Traditional Chinese Medicine Gargle for Chemotherapy-Induced Oral Mucositis: A Systematic Review and Meta-Analysis.

Objective: Chemotherapy-induced oral mucositis (CIOM) is an extremely serious complication of cancer. In China, the heat-clearing (Qingre) and detoxifying (Jiedu) traditional Chinese medicine QRJD-TCM gargle has been widely used to treat CIOM. To date, no systematic evaluation has been conducted on the clinical efficacy of QRJD-TCM gargle in treating CIOM. The objective of this systematic review and meta-analysis was to evaluate the efficacy of QRJD-TCM gargle in the treatment of CIOM. Methods: Relevant randomized controlled trials (RCTs) comparing QRJD-TCM gargle with conventional Western medicine mouthwash (CWMM) for CIOM were confirmed by systematically searching PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang Database, and Sinomed until October 20, 2020. Two researchers independently assessed the risk of bias according to the Cochrane risk-of-bias criteria. Excel 2010 was used in setting up a database of extracted information, and RevMan 5.3.0 was used in analyzing included trial data. The composition of the QRJD-TCM gargle was evaluated. Results: A total of 25 articles were included in this meta-analysis. Results showed that compared with CWMM, QRJD-TCM gargle can reduce the incidence of CIOM (OR = 0.23, 95% CI [0.18, 0.29], p < 0.00001) and severity of CIOM (grade I-II: OR = 0.36, 95%CI [0.28, 0.46], p < 0.00001; grade III-IV: OR = 0.15, 95%CI [0.09, 0.28], p < 0.00001). In addition, QRJD-TCM gargle improved the effective rate of CIOM (OR = 15.91, 95% CI [7.93, 31.89], p < 0.00001). Conclusion: QRJD-TCM gargle is effective in preventing and treating CIOM. However, more standard, double-blind, and multicenter randomized controlled studies are needed to further confirm the efficacy of QRJD-TCM gargle in the prevention and treatment of CIOM.