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Expert Rev Anticancer Ther . Impact of anti-cancer therapy on disease severity and mortality in cancer patients with COVID-19: a systematic review

tetano

Editor, Senior Moderator
Expert Rev Anticancer Ther


. 2021 May 10.
doi: 10.1080/14737140.2021.1927721. Online ahead of print.
Impact of anti-cancer therapy on disease severity and mortality in cancer patients with COVID-19: a systematic review and meta-analysis


Zhixian Lin[SUP] 1 [/SUP], Jiangfeng Chen[SUP] 2 [/SUP], Sunya Han[SUP] 3 [/SUP]



Affiliations

Abstract

Background: Coronavirus disease-2019 (COVID-19) poses a serious health threat to people around the world, particularly in patients with cancer. Whether or not cancer patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) receive anti-cancer therapy is associated with a poor prognosis is unclear. This systematic review and meta-analysis aims to assess 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: A comprehensive search was conducted on PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure (CNKI). The search timeperiod was from 1[SUP]st[/SUP] of December 2019 to 23[SUP]rd[/SUP] of January 2021, to identify observational studies that compared the disease severity and mortality of COVID-19 patients receiving and not receiving anti-cancer therapy. Two independent reviewers used the Newcastle-Ottawa Scale to evaluate the quality of the included studies. Data were input into the selected studies, meta-analysis was conducted using Revman 5.3 statistical software, and publication bias was analyzed.
Results: A total of 26 studies were included in this meta-analysis, involving 5571 cancer patients infected with SARS-CoV-2. Results 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, I[SUP]2[/SUP] =38%; 1956/2674, OR =1.27, 95% CI [0.95, 1.69], P =0.10, I[SUP]2[/SUP] =65%; 342/1455, OR =1.20, 95% CI [0.90, 1.61], P =0.21, I[SUP]2[/SUP] =7%; 503/1378, OR =0.92, 95% CI [0.72, 1.19], P =0.54, I[SUP]2[/SUP] =0%, respectively).
Conclusion: In cancer patients with COVID-19, anti-cancer therapy had no adverse effect on disease severity and mortality. Further research is necessary to determine the complex interrelationship between anti-cancer therapy, particularly chemotherapy, and COVID-19.

Keywords: Anti-cancer therapy; COVID-19; Disease severity; Meta-analysis; Mortality; SARS-CoV-2.
 
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