A systematic review and meta-analysis of cancer patients affected by a novel coronavirus

Abstract

Background Cancer patients with COVID-19 disease have been reported to have double the case fatality rate of the general population. Materials and methods A systematic search of PubMed/MEDLINE, Embase, Cochrane Central, Google Scholar, and MedRxiv was done for studies on cancer patients with COVID-19. Pooled proportions were calculated for categorical variables. Odds ratio and forest plots were constructed for both primary and secondary outcomes. The random-effects model was used to account for heterogeneity between studies. Results This systematic review of 31 studies and meta-analysis of 181,323 patients from 26 studies involving 23,736 cancer patients is the largest meta-analysis to the best of our knowledge assessing outcomes in cancer patients affected by COVID-19. Our meta-analysis shows that cancer patients with COVID-19 have a higher likelihood of death (odds ratio, OR 2.54), which was largely driven by mortality among patients in China. Cancer patients were more likely to be intubated, although ICU admission rates were not statistically significant. Among cancer subtypes, the mortality was highest in hematological malignancies (OR 2.43) followed by lung cancer (OR 1.8). There was no association between receipt of a particular type of oncologic therapy and mortality. Our study showed that cancer patients affected by COVID-19 are a decade older than the normal population and have a higher proportion of co-morbidities. There was insufficient data to assess the association of COVID-directed therapy and survival outcomes in cancer patients. Despite the heterogeneity of studies and inconsistencies in reported variables and outcomes, these data could guide clinical practice and oncologic care during this unprecedented global health pandemic. Conclusion Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity. A more nuanced understanding of the interaction between cancer-directed therapies and COVID-19-directed therapies is needed. This will require uniform prospective recording of data, possibly in multi-institutional registry databases.

https://researchopenworld.com/management-of-cancer-patients-undergoing-radiation-therapy-during-the-novel-coronavirus-disease-2019-covid-19-pandemic-a-review-of-the-literature/#

“…Patients who are symptomatic and/or have an oncologic emergency and a more prolonged life expectancy are recommended to receive short course palliative RT, delay of RT or best supportive in the case of limited life expectancy is otherwise recommended. Thureau et al in their GEMO (the European Study Group of Bone Metastases) position paper, astutely note that the indications and treatment modalities for palliative bone metastases must be re-discussed in the context of COVID-19 [64][65][66][67]. Palliative treatments often require the most clinical judgement and can benefit the most from available evidence surrounding reduction in the number of treatments and the complexity thereof in a resource strained setting.…”

Burden and prevalence of risk factors for severe COVID-19 disease in the ageing European population – A SHARE-based analysis

“…A review of six studies including 1527 patients with COVID-19 (mainly from Wuhan) found that the most prevalent cardiovascular comorbidities were hypertension (17.1%) and cardia-cerebrovascular disease (16.4%) followed by diabetes (9.7%) (Li et al 2020) . A systematic review and meta-analyses involving 23,736 cancer patients found that cancer patients with COVID-19 had higher mortality (OR = 2.54), however, largely driven by mortality among patients in China (Venkatesulu et al 2020).…”

Prognosis of COVID-19 in patients with breast cancer

“…[ 8 – 13 ] Previous meta-analyses also suggested that patients with a history of or active malignancy might be at increased risk of developing severe COVID-19 disease or mortality. [ 14 , 15 ] However, these meta-analyses did not evaluate which types of cancer are more associated with COVID-19 progression and prognosis. Breast cancer is the most frequently diagnosed malignancy and the most common cause of cancer-related mortality among women in 2018.…”