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Meta-Analysis
. 2020 Jun:6:799-808.
doi: 10.1200/GO.20.00225.

Effect of Cancer on Clinical Outcomes of Patients With COVID-19: A Meta-Analysis of Patient Data

Vassilis G Giannakoulis  1 , Eleni Papoutsi  1 , Ilias I Siempos  1   2
Affiliations
Meta-Analysis

Effect of Cancer on Clinical Outcomes of Patients With COVID-19: A Meta-Analysis of Patient Data

Vassilis G Giannakoulis et al. JCO Glob Oncol. 2020 Jun.

Abstract

Purpose: Whether cancer is associated with worse prognosis among patients with COVID-19 is unknown. We aimed to quantify the effect (if any) of the presence as opposed to absence of cancer on important clinical outcomes of patients with COVID-19 by carrying out a systematic review and meta-analysis.

Methods: We systematically searched PubMed, medRxiv, COVID-19 Open Research Dataset (CORD-19), and references of relevant articles up to April 27, 2020, to identify observational studies comparing patients with versus without cancer infected with COVID-19 and to report on mortality and/or need for admission to the intensive care unit (ICU). We calculated pooled risk ratios (RR) and 95% CIs with a random-effects model. The meta-analysis was registered with PROSPERO (CRD42020181531).

Results: A total of 32 studies involving 46,499 patients (1,776 patients with cancer) with COVID-19 from Asia, Europe, and the United States were included. All-cause mortality was higher in patients with versus those without cancer (2,034 deaths; RR, 1.66; 95% CI, 1.33 to 2.07; P < .0001; 8 studies with 37,807 patients). The need for ICU admission was also more likely in patients with versus without cancer (3,220 events; RR, 1.56; 95% CI, 1.31 to 1.87; P < .0001; 26 studies with 15,375 patients). However, in a prespecified subgroup analysis of patients > 65 years of age, all-cause mortality was comparable between those with versus without cancer (915 deaths; RR, 1.06; 95% CI, 0.79 to 1.41; P = .71; 8 studies with 5,438 patients).

Conclusion: The synthesized evidence suggests that cancer is associated with worse clinical outcomes among patients with COVID-19. However, elderly patients with cancer may not be at increased risk of death when infected with COVID-19. These findings may inform discussions of clinicians with patients about prognosis and may guide health policies.

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/go/site/misc/authors.html.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

No potential conflicts of interest were reported.

Figures

FIG 1
FIG 1
Study flow diagram. CORD-19, COVID-19 Open Research Dataset.
FIG 2
FIG 2
Forest plot for mortality. IV, inverse-variance.
FIG 3
FIG 3
Forest plot for need for intensive care unit admission. IV, inverse-variance.
FIG 4
FIG 4
Forest plot for age subgroup analysis. IV, inverse-variance.
See this image and copyright information in PMC

References

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MeSH terms