Outcome of Gynecologic Cancer Patients With The Covid-19 Infection : A Systematic Review And Meta Analysis

Abstract

Objective Cancer is comorbidity, which can lead to progressive worsening of Covid-19 with increased mortality. This is a systematic review and meta-analysis to get evidence of adverse outcomes of Covid-19 in gynecologic cancer. Methods Searches through PubMed, Google Scholar, ScienceDirect, and medRxiv to find articles on the outcome of gynecologic cancer with Covid-19 (24 July 2021-19 February 2022). Newcastle-Ottawa Scale tool used to evaluate the quality of included studies. Pooled odds ratio (OR), 95% confidence interval (CI), random-effects model were presented. This study was registered to PROSPERO (CRD42021256557). Results We accepted 49 studies with (1994 gynecologic cancer with Covid-19). Covid-19 infection was lower in gynecologic cancer vs hematologic cancer (OR 0.71, CI 0.56–0.89, p 0.003). Severe Covid and death were lower in gynecologic cancer vs lung and hematologic cancer (OR 0.36, CI 0.16–0.80, p 0.01), (OR 0.26, CI 0.10–0.67 p 0.005), (OR 0.52, CI 0.43–0.63, p < 0.0001), (OR 0.65, CI 0.49–0.87, p 0.003) respectively. Increased Covid death is seen in gynecologic cancer vs breast, non-covid cancer, and non-cancer covid (OR 1.51, CI 1.20–1.90, p 0.0004), (OR 12.21, CI 8.39–17.77, p < 0.0001), (OR 3.06, CI 2.32–4.04, p < 0.0001) respectively. Conclusion Gynecologic cancer had increased Covid-19 adverse outcomes compared to non-cancer, breast cancer, non-metastatic, and Covid-19 negative population. Gynecologic cancer had lowered Covid-19 adverse outcomes compared to other cancer types, lung cancer, and hematologic cancer. Lack of age and comorbidities stratification due to limited data were limitations. These findings may aid health policies and services during the ongoing global pandemic.