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Meta-Analysis
. 2021 Apr 6;113(4):371-380.
doi: 10.1093/jnci/djaa168.

Clinical Characteristics and Outcomes of COVID-19-Infected Cancer Patients: A Systematic Review and Meta-Analysis

Hua Zhang  1 , Han Han  1 , Tianhui He  2 , Kristen E Labbe  1 , Adrian V Hernandez  3   4 , Haiquan Chen  5 , Vamsidhar Velcheti  1 , Justin Stebbing  6 , Kwok-Kin Wong  1
Affiliations
Meta-Analysis

Clinical Characteristics and Outcomes of COVID-19-Infected Cancer Patients: A Systematic Review and Meta-Analysis

Hua Zhang et al. J Natl Cancer Inst. .

Erratum in

Expression of concern in

Abstract

Background: Previous studies have indicated coronavirus disease 2019 (COVID-19) patients with cancer have a high fatality rate.

Methods: We conducted a systematic review of studies that reported fatalities in COVID-19 patients with cancer. A comprehensive meta-analysis that assessed the overall case fatality rate and associated risk factors was performed. Using individual patient data, univariate and multivariable logistic regression analyses were used to estimate odds ratios (OR) for each variable with outcomes.

Results: We included 15 studies with 3019 patients, of which 1628 were men; 41.0% were from the United Kingdom and Europe, followed by the United States and Canada (35.7%), and Asia (China, 23.3%). The overall case fatality rate of COVID-19 patients with cancer measured 22.4% (95% confidence interval [CI] = 17.3% to 28.0%). Univariate analysis revealed age (OR = 3.57, 95% CI = 1.80 to 7.06), male sex (OR = 2.10, 95% CI = 1.07 to 4.13), and comorbidity (OR = 2.00, 95% CI = 1.04 to 3.85) were associated with increased risk of severe events (defined as the individuals being admitted to the intensive care unit, or requiring invasive ventilation, or death). In multivariable analysis, only age greater than 65 years (OR = 3.16, 95% CI = 1.45 to 6.88) and being male (OR = 2.29, 95% CI = 1.07 to 4.87) were associated with increased risk of severe events.

Conclusions: Our analysis demonstrated that COVID-19 patients with cancer have a higher fatality rate compared with that of COVID-19 patients without cancer. Age and sex appear to be risk factors associated with a poorer prognosis.

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Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram. Flow chart of screen and study selection.
Figure 2.
Figure 2.
Forest plot of overall case fatality rate of patients with cancer and Coronavirus disease 2019 (COVID-19) from 14 individual studies analyzed. The Cochran’s Q test was used to identify heterogeneity and to calculate the P values. Heterogeneity was further quantified using I2 as described in the Methods. CI = confidence interval.
Figure 3.
Figure 3.
Forest plot of overall case fatality rate in the subgroup analysis. Overall case fatality rate in different cancer types: (A) lung cancer, (B) other solid cancer, and (C) hematological cancer; and in different cancer treatment: (D) chemotherapy, (E) surgery, (F) immunotherapy, (G) radiotherapy, and (H) targeted therapy. The Cochran’s Q test was used to identify heterogeneity and to calculate the P values. Heterogeneity was further quantified using I2 as described in the Methods. CI = confidence interval.
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References

    1. Guan WJ, Ni ZY, Hu Y, et al.Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720. - PMC - PubMed
    1. Chen N, Zhou M, Dong X, et al.Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513. - PMC - PubMed
    1. Wu Z, McGoogan JM.. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239. - PubMed
    1. Dong E, Du H, Gardner L.. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20(5):533-534. - PMC - PubMed
    1. Bray F, Ferlay J, Soerjomataram I, et al.Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. - PubMed

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