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J Natl Cancer Inst
. 2020 Nov 2;djaa168.
doi: 10.1093/jnci/djaa168. Online ahead of print.
Clinical Characteristics and Outcomes of COVID-19-Infected Cancer Patients: A Systematic Review and Meta-Analysis
Hua Zhang 1 , Han Han 1 , Tianhui He 2 , Kristen E Labbe 1 , Adrian V Hernandez 3 4 , Haiquan Chen 5 , Vamsidhar Velcheti 1 , Justin Stebbing 6 , Kwok-Kin Wong 1
Affiliations
- PMID: 33136163
- DOI: 10.1093/jnci/djaa168
Abstract
Background: Previous studies have indicated Coronavirus disease 2019 (COVID-19) patients with cancer have a high fatality rate.
Methods: We conducted a systematic review of studies that reported fatalities in COVID-19 patients with cancer. A comprehensive meta-analysis that assessed the overall case fatality rate and associated risk factors was performed. Using individual patient data, univariate and multivariate logistic regression analyses were used to estimate odds ratios (OR) for each variable with outcomes.
Results: We included 15 studies with 3019 patients, of which 1628 were men; 41.0% were from the UK and Europe, followed by the USA and Canada (35.7%) and Asia (China, 23.3%). The overall case fatality rate of COVID-19 patients with cancer measured 22.4% (95% confidence interval [CI] = 17.3% to 28.0%). Univariate analysis revealed age (odds ratio [OR] = 3.57; 95% CI = 1.80 to 7.06), male (OR = 2.10; 95% CI = 1.07 to 4.13), and comorbidity (OR = 2.00; 95% CI = 1.04 to 3.85) were associated with increased risk of severe events (defined as the individuals being admitted to the intensive care unit, or requiring invasive ventilation, or death). In multivariate analysis, only age greater than 65 years (OR = 3.16; 95% CI = 1.45 to 6.88) and being male (OR = 2.29; 95% CI = 1.07 to 4.87) were associated with increased risk of severe events.
Conclusion: Our analysis demonstrated that COVID-19 patients with cancer have a higher fatality rate when compared with that of COVID-19 patients without cancer. Age and gender appear to be risk factors associated with a poorer prognosis.
Keywords: COVID-19; cancer; fatality rate; meta-analysis; systematic review.