Effects of SARS-CoV-2 infections in patients with cancer on mortality, ICU admission and incidence: a systematic review with meta-analysis involving 709,908 participants and 31,732 cancer patients

Abstract

Background Cancer patients constitute one of the highest-risk patient groups during the COVID-19 pandemic. In this study, it was aimed to perform a systematic review and meta-analysis to determine both the incidence and ICU (Intensive Care Unit) admission rates and mortality in SARS-CoV-2 infected cancer patients. Methods The PRISMA guidelines were closely followed during the design, analysis, and reporting of this systematic review and meta-analysis. A comprehensive literature search was performed for the published papers in PubMed/Medline, Scopus, medRxiv, Embase, and Web of Science (WoS) databases. SARS-CoV-2 infection pooled incidence in the cancer populations and the risk ratio (RR) of ICU admission rates/mortality in cancer and non-cancer groups, with 95% confidence intervals (CIs), were calculated using the random-effects model. Results A total of 58 studies, involving 709,908 participants and 31,732 cancer patients, were included in this study. The incidence in cancer patients was calculated as 8% (95% CI: 8–9%). Analysis results showed that mortality and ICU admission rate was significantly higher in patients with cancer (RR = 2.26, 95% CI: 1.94–2.62, P < 0.001; RR = 1.45, 95% CI: 1.28–1.64, p < 0.001, respectively). Conclusion As a result, cancer was an important comorbidity and risk factor for all SARS-CoV-2 infected patients. This infection could result in severe and even fatal events in cancer patients. Cancer is associated with a poor prognosis in the COVID-19 pandemic. Cancer patients should be assessed more sensitively in the COVID-19 outbreak. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-022-04191-y.

The impact of cancer on the severity of disease in patients affected with COVID-19: an umbrella review and meta-meta-analysis of systematic reviews and meta-analyses involving 1,064,476 participants

“…We identified 570 papers (Web of Science: 172, PubMed/Medline: 181, Scopus: 217) from the initial search in related databases, of which 241 were excluded for duplicate records and title and abstract. Of the twenty-seven articles whose full texts were reviewed in detail, ten [ 16 – 25 ] of the studies that met the inclusion criteria, hospitalization in the ICU was reported. Relevant literature searches and the study selection process are illustrated in Fig.…”

“…The number of research and participants of the studies included in the meta-meta-analysis is as follows: a total of 58 studies and 709,908 participants were included in the meta-analysis performed by Arayici et al [ 16 ], a total of 81 primary research and 61,532 individuals were included in the meta-analysis performed by Khoury et al [ 17 ], a total of 35 studies and 142,355 participants were included in the meta-analysis performed by Di Felice et al [ 18 ], a total of 57 papers and 63,413 participants were included in the meta-analysis performed by Han et al [ 20 ], a total of 26 studies and 181,323 participants were included in the meta-analysis performed by Venkatesulu et al [ 21 ], a total of 19 studies and 63,019 individuals were included in the meta-analysis performed by Yang et al [ 22 ], a total of 13 papers and 3,775 participants were included in the meta-analysis performed by Salunke et al [ 24 ], a total of 38 primary research and 7,094 participants were included in the meta-analysis performed by Tian et al [ 23 ], a total of 32 research and 46,499 participants were included in the meta-analysis performed by Giannakoulis et al [ 19 ], and a total of 14 papers and 29,900 participants were included in the meta-analysis performed by Parohan et al [ 25 ].…”

“…A total of five systematic reviews and meta-analyses [ 16 , 18 , 19 , 21 , 24 ] assessed the association between COVID-19 and ICU admission for cancer patients. The pooled ES which was calculated for ICU admission was significantly increased in cancer patients affected by COVID-19 (OR = 1.84, %95 CI: 1.44–2.34, p < 0.001) (Fig.…”

“…In meta-analyses with samples of various sizes published in the literature, it was reported that cancer increased susceptibility to SARS-CoV-2 infection and underlined that it is a risk factor for poor clinical outcomes in COVID-19 patients [ 16 – 25 ]. There has been a considerable increase in the number of meta-analyses reporting the severity of COVID-19 on cancer patients.…”

“…There has been a considerable increase in the number of meta-analyses reporting the severity of COVID-19 on cancer patients. Numerous meta-analyses have been published, reporting both death and ICU admission rates in cancer patients by COVID-19 [ 16 – 25 ]. Therefore, these meta-analyses need to be combined with an umbrella review and meta-meta-analysis method and re-evaluated with increased power.…”