Clinical characteristics and outcomes of COVID-19-infected cancer patients: a systematic review and meta-analysis

Title: Clinical characteristics and outcomes of COVID-19-infected cancer patients: a systematic review and meta-analysis
Authors: Zhang, H
Han, H
He, T
Labbe, KE
Hernandez, AV
Chen, H
Velcheti, V
Stebbing, J
Wong, K-K
Item 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.
Issue Date: 2-Nov-2020
Date of Acceptance: 14-Oct-2020
DOI: 10.1093/jnci/djaa168
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: 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:
Sponsor/Funder: Imperial College Healthcare NHS Trust- BRC Funding
National Institute for Health Research
Funder's Grant Number: RDB01 79560
Keywords: COVID-19
fatality rate
systematic review
Oncology & Carcinogenesis
1112 Oncology and Carcinogenesis
Publication Status: Published
Conference Place: United States
Online Publication Date: 2020-11-02
Appears in Collections:Department of Surgery and Cancer
Faculty of Medicine
Imperial College London COVID-19