Clinical characteristics and outcomes of COVID-19-infected cancer patients: a systematic review and meta-analysis
Author(s)
Type
Journal Article
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.
Date Issued
2020-11-02
Date Acceptance
2020-10-14
Citation
Journal of the National Cancer Institute, 2020, 113 (4), pp.371-380
ISSN
0027-8874
Publisher
Oxford University Press (OUP)
Start Page
371
End Page
380
Journal / Book Title
Journal of the National Cancer Institute
Volume
113
Issue
4
Copyright Statement
© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com. This is a pre-copy-editing, author-produced version of an article accepted for publication in Journal of the National Cancer Institute following peer review. The definitive publisher-authenticated version is available online at: https://academic.oup.com/jnci/advance-article/doi/10.1093/jnci/djaa168/5951181
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
National Institute for Health Research
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33136163
PII: 5951181
Grant Number
RDB01 79560
NIHR-RP-011-053
Subjects
COVID-19
cancer
fatality rate
meta-analysis
systematic review
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2020-11-02