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Meta-Analysis
. 2021 Feb 15;18(1):298-307.
doi: 10.20892/j.issn.2095-3941.2020.0559.

Effects of cancer on patients with COVID-19: a systematic review and meta-analysis of 63,019 participants

Ludi Yang  1 , Peiwei Chai  1 , Jie Yu  1 , Xianqun Fan  1
Affiliations
Meta-Analysis

Effects of cancer on patients with COVID-19: a systematic review and meta-analysis of 63,019 participants

Ludi Yang et al. Cancer Biol Med. .

Abstract

Objective: Patients with underlying diseases are more vulnerable to coronavirus disease 2019 (COVID-19). The purpose of this study was to investigate cancer incidence in patients with COVID-19 and to determine whether cancer was associated with mortality among patients with COVID-19.

Methods: Electronic searches of PubMed, Embase, Cochrane, Web of Science, and medRxiv were conducted to collect studies that provided data regarding the incidence and mortality of cancer patients with COVID-19. Meta-analyses were used to estimate pooled incidences, risk ratios (RRs), and 95% confidence intervals (CIs) using a random-effects model. Heterogeneity among studies was detected using I2 statistics.

Results: A total of 19 retrospective studies involving 63,019 patients (2,682 patients with cancer) were included. Meta-analysis showed that the pooled incidence of cancer in COVID-19 patients was 6% (95% CI: 3%-9%). The mortality rate of COVID-19 patients with cancer was higher than that of those without cancer [risk ratio (RR): 1.8, 95% CI: 1.38-2.35, P < 0.01]. Studies on specific types of cancer showed that among COVID-19 patients, the mortality rate of lung cancer patients was higher than that of patients without lung cancer (RR: 1.8, 95% CI: 0.85-3.80, P = 0.02).

Conclusions: Patients with cancer were more susceptible to COVID-19. As a risk factor, cancer increased mortality among COVID-19 patients. Among COVID-19 patients with cancer, those who had lung cancer had a higher mortality than those without lung cancer. Our findings suggested that clinicians should pay more attention to cancer patients diagnosed with COVID-19 and provide useful information for their clinical management.

Keywords: COVID-19; cancer; incidence; meta-analysis; mortality.

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Conflict of interest statement

Conflict of interest statement No potential conflicts of interest are disclosed.

Figures

Figure 1
Figure 1
Flow chart of the search process.
Figure 2
Figure 2
Forest plot showing the incidence of cancer in COVID-19 patients.
Figure 3
Figure 3
Sensitivity analysis of cancer incidence in COVID-19 patients.
Figure 4
Figure 4
Forest plot showing the mortality of cancer patients with COVID-19.
Figure 5
Figure 5
Sensitivity analysis of cancer mortality in COVID-19 patients.
Figure 6
Figure 6
Forest plot showing the mortality of lung cancer patients vs. non-lung cancer patients among the COVID-19 population.
See this image and copyright information in PMC

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