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Meta-Analysis
. 2021 Jul:157:60-65.
doi: 10.1016/j.lungcan.2021.05.002. Epub 2021 May 5.

Higher mortality in lung cancer patients with COVID-19? A systematic review and meta-analysis

Haike Lei  1 , Yue Yang  1 , Wei Zhou  1 , Mengyang Zhang  1 , Yang Shen  1 , Dan Tao  1 , Lulu Wang  1 , Qianqian Lei  1 , Ying Wang  2 , Yongzhong Wu  3
Affiliations
Meta-Analysis

Higher mortality in lung cancer patients with COVID-19? A systematic review and meta-analysis

Haike Lei et al. Lung Cancer. 2021 Jul.

Abstract

Objective: Given that the coronavirus disease 2019 (COVID-19) mainly spreads through the respiratory system and is associated with severe pulmonary complications, lung cancer patients may have worse outcomes than those with other tumors. There is no confirmed evidence about the mortality comparison between COVID-19 patients with lung cancer and other tumors. We performed a systematic review and pooled analysis to provide precise estimates of the mortality rate of COVID-19 patients with lung cancer and other tumors.

Materials and methods: Our study systemically included and reviewed 13 studies on the characteristics of COVID-19 patients with lung cancer published up to November 1, 2020. The primary endpoint was all-cause mortality. We also compared the all-cause mortality rates in China and other regions as a secondary endpoint. The mortality rate was assessed with a fixed-effects model, which was used to derive the pooled mortality and 95 % confidence interval (CI).

Results: Thirteen studies from different countries, involving 1,229 patients with both COVID-19 and cancer, were selected for the pooled analysis. A total of 343 deaths were recorded in this population: 86 for lung cancers and 257 for other tumors. The mortality rate varies from 18 % to 60 % for patients with lung cancer and COVID-19 and 10%-41% for other tumor patients with COVID-19. The overall meta-analysis did not show a significant mortality difference for the lung cancer and other tumor subgroups (OR = 1.47, 95 %CI = 0.98-2.20, p = 0.06, I2 = 23 %). Nevertheless, in regions other than China, the pooled mortality of lung cancer patients with COVID-19 was 42 %, which was significantly higher than that of other tumors (24 %) (OR = 2.73, 95 % CI = 1.54-4.86, p = 0.0006, I2 = 16 %).

Conclusion: Appropriate and aggressive preventive measures should be implemented to reduce the risk of COVID-19 in patients with cancer and optimally manage those who contract the infection.

Keywords: COVID-19; Lung cancer; Mortality; Pandemic; SARS-CoV-2.

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Conflict of interest statement

The authors report no declarations of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for the selection of studies to be included in the systematic review and meta-analysis.
Fig. 2
Fig. 2
Forest plot of pooled all-cause mortality rates of lung cancer patients and other tumors patients with COVID-19.
Fig. 3
Fig. 3
Forest plot of pooled all-cause mortality rates of lung cancer patients and other tumors patients with COVID-19 in China.
Fig. 4
Fig. 4
Forest plot of pooled all-cause mortality rates of lung cancer patients and other tumors patients with COVID-19 in other regions.
Fig. 5
Fig. 5
Funnel plot for the results from (a) all studies and those from (b) China and (c) other regions.
See this image and copyright information in PMC

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