Impact of anti-cancer therapy on disease severity and mortality in cancer patients with COVID-19: a systematic review and meta-analysis

Lin, Zhixian; Chen, Jiangfeng; Han, Sunya

doi:10.1080/14737140.2021.1927721

Cited by 10 publications

(11 citation statements)

References 48 publications

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“…Moreover, it remains uncertain whether recent antineoplastic systemic therapy use, particularly cytotoxic chemotherapy, is a risk factor for poor COVID‐19 outcomes. A recent meta‐analysis of 26 cohort studies found no adverse effect of various anti‐cancer therapies on COVID‐19 severity or mortality, 11 perhaps due to the categorization of heterogeneous groups of therapies. Detailed examination of outcomes based on specific therapies is needed.…”

Section: Introductionmentioning

confidence: 99%

COVID‐19 outcomes in patients with cancer: Findings from the University of California health system database

et al. 2022

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Background The interaction between cancer diagnoses and COVID‐19 infection and outcomes is unclear. We leveraged a state‐wide, multi‐institutional database to assess cancer‐related risk factors for poor COVID‐19 outcomes. Methods We conducted a retrospective cohort study using the University of California Health COVID Research Dataset, which includes electronic health data of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) at 17 California medical centers. We identified adults tested for SARS‐CoV‐2 from 2/1/2020–12/31/2020 and selected a cohort of patients with cancer. We obtained demographic, clinical, cancer type, and antineoplastic therapy data. The primary outcome was hospitalization within 30d after the first positive SARS‐CoV‐2 test. Secondary outcomes were SARS‐CoV‐2 positivity and severe COVID‐19 (intensive care, mechanical ventilation, or death within 30d after the first positive test). We used multivariable logistic regression to identify cancer‐related factors associated with outcomes. Results We identified 409,462 patients undergoing SARS‐CoV‐2 testing. Of 49,918 patients with cancer, 1781 (3.6%) tested positive. Patients with cancer were less likely to test positive (RR 0.70, 95% CI: 0.67–0.74, p < 0.001). Among the 1781 SARS‐CoV‐2‐positive patients with cancer, BCR/ABL‐negative myeloproliferative neoplasms (RR 2.15, 95% CI: 1.25–3.41, p = 0.007), venetoclax (RR 2.96, 95% CI: 1.14–5.66, p = 0.028), and methotrexate (RR 2.72, 95% CI: 1.10–5.19, p = 0.032) were associated with greater hospitalization risk. Cancer and therapy types were not associated with severe COVID‐19. Conclusions In this large, diverse cohort, cancer was associated with a decreased risk of SARS‐CoV‐2 positivity. Patients with BCR/ABL‐negative myeloproliferative neoplasm or receiving methotrexate or venetoclax may be at increased risk of hospitalization following SARS‐CoV‐2 infection. Mechanistic and comparative studies are needed to validate findings.

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Section: Introductionmentioning

confidence: 99%

COVID‐19 outcomes in patients with cancer: Findings from the University of California health system database

et al. 2022

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“…In recent meta-analyses, 29 , 42 chemotherapy, surgery, or other anticancer treatments were not associated with increased risk of COVID-19 disease severity or deaths in cancer patients with COVID-19 disease.…”

Section: Resultsmentioning

confidence: 95%

“…Recent anticancer treatment before COVID-19 disease has been associated with increased severity of COVID-19 disease or mortality in some studies [47][48][49] but not in others. In recent meta-analyses, 29,42 chemotherapy, surgery, or other anticancer treatments were not associated with increased risk of COVID-19 disease severity or deaths in cancer patients with COVID-19 disease.…”

Section: Health System Capacity During a Pandemicmentioning

confidence: 96%

“…with cancer might have increased risk of COVID-19 disease. [29][30][31] Although the large case-control study had limitations such as those inherent to electronic health records and testing differences between groups, patients with cancer especially those diagnosed within the past year were at significantly increased risk compared with those who never had cancer, and the associations were strongest for those patients with recently diagnosed leukemia, non-Hodgkin lymphoma, and lung cancer. 31 Severity and complications of COVID-19 disease in patients with cancer.…”

Section: Health System Capacity During a Pandemicmentioning

confidence: 99%

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Conceptual Framework for Cancer Care During a Pandemic Incorporating Evidence From the COVID-19 Pandemic

Milch

Nelson²,

Austen

et al. 2022

JCO Global Oncology

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PURPOSE With successive infection waves and the spread of more infectious variants, the COVID-19 pandemic continues to have major impacts on health care. To achieve best outcomes for patients with cancer during a pandemic, efforts to minimize the increased risk of severe pandemic infection must be carefully balanced against unintended adverse impacts of the pandemic on cancer care, with consideration to available health system capacity. Cancer Australia's conceptual framework for cancer care during a pandemic provides a planning resource for health services and policy-makers that can be broadly applied globally and to similar pandemics. METHODS Evidence on the impact of the COVID-19 pandemic on cancer care and health system capacity to June 2021 was reviewed, and the conceptual framework was developed and updated. RESULTS Components of health system capacity vary during a pandemic, and capacity relative to pandemic numbers and severity affects resources available for cancer care delivery. The challenges of successive pandemic waves and high numbers of pandemic cases necessitate consideration of changing health system capacity in decision making about cancer care. Cancer Australia’s conceptual framework provides guidance on continuation of care across the cancer pathway, in the face of challenges to health systems, while minimizing infection risk for patients with cancer and unintended consequences of delays in screening, diagnosis, and cancer treatment and backlogs because of service interruption. CONCLUSION Evidence from the COVID-19 pandemic supports continuation of cancer care wherever possible during similar pandemics. Cancer Australia's conceptual framework, underpinned by principles for optimal cancer care, informs decision making across the cancer care continuum. It incorporates consideration of changes in health system capacity and capacity for cancer care, in relation to pandemic progression, enabling broad applicability to different global settings.

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“…Fortunately, the development of vaccines has been shown to be effective in those with cancer leading to high rates of seroconversion, although patients with hematologic malignancies and those receiving immunosuppressive therapies have somewhat blunted responses [47]. For those continuing to receive anti-cancer treatments, the data on adverse effects from COVID-19 are mixed with some studies demonstrating an increased risk [48,49] and others showing no increase in risk [50,51] With additional questions including how long vaccines will last and what variants will emerge next, the only certainty appears that things will continue to be uncertain, giving more reason to further develop and improve cancer telerehabilitation (Fig. 1).…”

Section: Future Directionsmentioning

confidence: 99%

Updates in Cancer Rehabilitation Telehealth

Chang

Zheng

2022

Curr Phys Med Rehabil Rep

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Purpose of ReviewTo describe the various uses of telehealth as it applies to cancer rehabilitation and to review recent findings since the onset of the COVID-19 pandemic.Recent Findings Telehealth has numerous applications in cancer rehabilitation including physiatry services, skilled therapies, exercise interventions, symptom management, and support groups. Numerous studies have shown that regular physician and skilled therapy services can be provided through telehealth platforms, though certain clinical situations may require in-person visits. Telehealth exercise-based interventions are feasible, safe, and can improve quality of life. Telehealth also may be an effective tool in symtom management and as a medium for support groups. Summary Telemedicine and telehealth platforms are effective tools in the field of cancer rehabilitation that not only provide increased safety and convenience for a burdened patient population but may also hold the potential to elevate beyond the current standard of care.

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Impact of anti-cancer therapy on disease severity and mortality in cancer patients with COVID-19: a systematic review and meta-analysis

Cited by 10 publications

References 48 publications

COVID‐19 outcomes in patients with cancer: Findings from the University of California health system database

COVID‐19 outcomes in patients with cancer: Findings from the University of California health system database

Conceptual Framework for Cancer Care During a Pandemic Incorporating Evidence From the COVID-19 Pandemic

Updates in Cancer Rehabilitation Telehealth

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