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

Abstract

During the COVID-19 pandemic, cancer patients were among the most vulnerable patient groups to the SARS-CoV-2 infection effects. This paper aimed to conduct an umbrella review and meta-meta-analysis to determine the severity of disease in cancer patients affected by COVID-19. The umbrella review and meta-meta-analysis were undertaken according to the PRISMA and MOOSE guidelines. The PubMed/Medline, Web of Science, and Scopus databases were searched for published papers from the start of the pandemic through July 18, 2022. The pooled effect sizes (ES) and odds ratios (ORs) were calculated using a random effect model in the 95% confidence interval (CI) for ICU (Intensive Care Unit) admissions and mortality in cancer patients infected with SARS-CoV-2. Egger's linear regression test, schematic illustrations of funnel plots, and Begg and Mazumdar’s rank correlation tests were used to quantify the possibility of publication bias. The pooled ES was calculated based on 1,031,783 participants, and mortality was significantly increased in cancer patients affected by COVID-19 (OR = 2.02, %95 CI: 1.74–2.35, p < 0.001). The pooled ES for ICU admission was also significantly increased in cancer patients infected with SARS-CoV-2 (OR = 1.84, %95 CI: 1.44–2.34, p < 0.001). As a result, this synthesis of systematic reviews and meta-analyses by the meta-meta-analysis method revealed that disease severity is higher in cancer patients affected by COVID-19. Since cancer patients are a more sensitive and specific patient group, they should be evaluated more carefully, especially during the COVID-19 pandemic and other pandemics that may occur in the future. Supplementary Information The online version contains supplementary material available at 10.1007/s10238-022-00911-3.

Vitamin D Intake, Serum 25-Hydroxyvitamin-D (25(OH)D) Levels, and Cancer Risk: A Comprehensive Meta-Meta-Analysis Including Meta-Analyses of Randomized Controlled Trials and Observational Epidemiological Studies

“…The quality of meta-analyses was evaluated utilizing the 16-item AMSTAR-2 (A Mea-Surement Tool to Assess Systematic Reviews) tool (Table S3) [28]. Seven of the sixteen items in AMSTAR-2 were classified as crucial items (items 2,4,7,9,11,13,15). AMSTAR-2 has been defined as an evaluation tool, developed to enable the evaluation of systematic reviews of randomized and non-randomized studies of health interventions.…”

“…Cancer, which is a complicated group of malignant disorders characterized by abnormal cell proliferation and an uncontrolled cell cycle, remains a major cause of death globally, regardless of human development levels, in countries all over the world [ 1 , 2 , 3 , 4 ]. According to Global Cancer Observatory (GLOBOCAN) data, approximately 19.3 million new cancer cases were reported, and 10 million deaths were attributed to cancer worldwide in 2020 [ 2 , 3 ].…”

<strong>Vitamin D Intake, Serum 25-hydroxyvitamin-D (25(OH)D) Levels, and Cancer Risk: a Comprehensive Meta-meta-analysis including Meta-analyses of Randomized Controlled Trials and Observational Epidemiological Studies</strong>

“…Cancer, which comprises a diverse set of diseases characterized by irregular cell proliferation and an unregulated cell cycle, remains a major cause of death globally, regardless of human development levels in countries all over the world [1][2][3][4]. According to Global Cancer Observatory (GLOBOCAN) data, approximately 19.3 million new cancer cases were reported, and 10 million deaths were attributed to cancer worldwide in 2020 [2,3].…”

Perspectives and Challenges of COVID-19 with Obesity-Related Cancers

“…Two umbrella reviews and meta-analyses on the association between pre-existing health conditions and severe outcomes from COVID-19 have shown that other than diabetes, obesity, heart failure, chronic obstructive pulmonary disease and dementia, active cancer was also linked with a higher risk of death, particularly in Europe and North America [ 22 , 23 ]. Oncologic patients may be more susceptible to SARS-CoV-2 infection.…”

“…Evidence is mixed regarding COVID-19 severity in cancer patients [ 24 , 25 , 26 ], while COVID-19 outcomes in these patients are improved with an earlier diagnosis, the availability of effective COVID-19 vaccines, the advent of the omicron outbreak and the timely use of anti-viral therapy [ 24 , 27 ]. Despite all the abovementioned factors, most studies have highlighted an elevated risk of severe COVID-19 in patients with active cancer, particularly in non-vaccinated individuals [ 22 , 23 , 25 , 28 , 29 ]. The risk may vary by type and stage of cancer and treatment.…”