Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Jun 1;15(2):45-53.
doi: 10.1016/j.hemonc.2020.07.005.

The Risk and Prognosis of COVID-19 Infection in Cancer Patients: A Systematic Review and Meta-Analysis

Ghada M ElGohary  1   2 , Shahrukh Hashmi  3 , Jan Styczynski  4 , Mohamed A Kharfan-Dabaja  5 , Rehab M Alblooshi  6 , Rafael de la Cámara  7 , Sherif Mohmed  8 , Alfadel Alshaibani  9 , Simone Cesaro  10 , Nashwa Abd El-Aziz  11   12 , Reem Almaghrabi  13 , Usama Gergis  14 , Navneet S Majhail  15 , Yasser El-Gohary  16 , Roy F Chemaly  17 , Mahmoud Aljurf  9 , Riad El Fakih  9
Affiliations
Meta-Analysis

The Risk and Prognosis of COVID-19 Infection in Cancer Patients: A Systematic Review and Meta-Analysis

Ghada M ElGohary et al. Hematol Oncol Stem Cell Ther. .

Abstract

Numerous studies have been published regarding outcomes of cancer patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus causing the coronavirus disease 2019 (COVID-19) infection. However, most of these are single-center studies with a limited number of patients. To better assess the outcomes of this new infection in this subgroup of susceptible patients, we performed a systematic review and meta-analysis to evaluate the impact of COVID-19 infection on cancer patients. We performed a literature search using PubMed, Web of Science, and Scopus for studies that reported the risk of infection and complications of COVID-19 in cancer patients and retrieved 22 studies (1018 cancer patients). The analysis showed that the frequency of cancer among patients with confirmed COVID-19 was 2.1% (95% confidence interval [CI]: 1.3-3) in the overall cohort. These patients had a mortality of 21.1% (95% CI: 14.7-27.6), severe/critical disease rate of 45.4% (95% CI: 37.4-53.3), intensive care unit (ICU) admission rate of 14.5% (95% CI: 8.5-20.4), and mechanical ventilation rate of 11.7% (95% CI: 5.5-18). The double-arm analysis showed that cancer patients had a higher risk of mortality (odds ratio [OR]=3.23, 95% CI: 1.71-6.13), severe/critical disease (OR=3.91, 95% CI: 2.70-5.67), ICU admission (OR=3.10, 95% CI: 1.85-5.17), and mechanical ventilation (OR=4.86, 95% CI: 1.27-18.65) than non-cancer patients. Furthermore, cancer patients had significantly lower platelet levels and higher D-dimer levels, C-reactive protein levels, and prothrombin time. In conclusion, these results indicate that cancer patients are at a higher risk of COVID-19 infection-related complications. Therefore, cancer patients need diligent preventive care measures and aggressive surveillance for earlier detection of COVID-19 infection.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of literature search and study selection. Note. PRISMA = preferred reporting items for systematic reviews and meta-analyses.
Fig. 2
Fig. 2
Forest plot showing single-arm analysis of cancer frequency among patients with COVID-19. Note. COVID-19 = coronavirus disease 2019.
Fig. 3
Fig. 3
Forest plot showing double-arm analysis comparing the risk of mortality between cancer and non-cancer groups. Note. OR = odds ratio; 95% CI = confidence interval.
Fig. 4
Fig. 4
Forest plot showing double-arm analysis comparing the risk of severe/critical COVID-19 disease between cancer and non-cancer groups. Note. OR = odds ratio; 95% CI = confidence interval.
Fig. 5
Fig. 5
Forest plot showing double-arm analysis comparing the risk of ICU admission between cancer and non-cancer groups. Note. OR = odds ratio; 95% CI = confidence interval.
Fig. 6
Fig. 6
Forest plot showing double-arm analysis comparing the risk of mechanical ventilation between cancer and non-cancer groups. Note. OR = odds ratio; 95% CI = confidence interval.
See this image and copyright information in PMC

References

    1. Wang C., Horby P.W., Hayden F.G., Gao G.F. A novel coronavirus outbreak of global health concern. Lancet. 2020;395:470–473. - PMC - PubMed
    1. Guan W.J., Liang W.H., Zhao Y., Liang H.R., Chen Z.S., Li Y.M. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020;55:2000547. doi: 10.1183/13993003.00547-2020. - DOI - PMC - PubMed
    1. Miyashita H., Mikami T., Chopra N., Yamada T., Chernyavsky S., Rizk D. Do patients with cancer have a poorer prognosis of COVID-19? An experience in New York City. Ann Oncol. 2020 doi: 10.1038/s42003-020-1088-9. - DOI - PMC - PubMed
    1. He W., Chen L., Chen L., Yuan G., Fang Y., Chen W. COVID-19 in persons with haematological cancers. Leukemia. 2020;34:1637–1645. doi: 10.1038/s41375-020-0836-7. - DOI - PMC - PubMed
    1. Burki T.K. Cancer guidelines during the COVID-19 pandemic. Lancet Oncol. 2020;21:629–630. - PMC - PubMed