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Meta-Analysis
. 2021 Dec;101(Pt A):108242.
doi: 10.1016/j.intimp.2021.108242. Epub 2021 Oct 11.

Does prior exposure to immune checkpoint inhibitors treatment affect incidence and mortality of COVID-19 among the cancer patients: The systematic review and meta-analysis

Yang Liu  1 , Shuo Liu  2 , Yujun Qin  3 , Lei Zhao  3 , Yiliang Li  4 , Chenghui Zhou  5 , Wei Chen  6
Affiliations
Meta-Analysis

Does prior exposure to immune checkpoint inhibitors treatment affect incidence and mortality of COVID-19 among the cancer patients: The systematic review and meta-analysis

Yang Liu et al. Int Immunopharmacol. 2021 Dec.

Abstract

Background: Immune checkpoint inhibitors (ICIs) treatment among cancer patients has been shown to have antiviral effects by reactivating exhausted T cells. However, they could also trigger inflammatory storm. Therefore, prior exposure to ICIs may influence the risk of SARS-CoV2 infection and subsequent mortality. Recent results from studies of ICIs treatment on incidence and mortality of COVID-19 are controversial.

Materials and methods: We searched databases PubMed, Embase, ISI of Knowledge, Cochrane Central Register of Controlled Trials (CENTRAL), as well as pre-print databases (MedRxiv and BioRxiv) for retrospective and prospective studies comparing ICIs versus other antitumor treatments in cancer patients in the area of COVID-19 pandemic. The primary outcome was the incidence of COVID-19. The secondary outcomes were mortality of COVID-19.

Results: Twenty-three studies with a total of 117,735 patients were selected. Compared with other antitumor treatments, prior exposure to ICIs had not an increased risk of incidence [Odds ratio (OR), 0.84; 95% confidence interval (CI), 0.60-1.18; P = 0.32] and mortality (OR, 1.22; 95% CI, 0.91-1.62; P = 0.18) of COVID-19 infectioin. Our subgroup and meta-regression analyses indicated that prior exposure to ICIs may reduce the incidence of COVID-19 in metastatic cancer patients.

Conclusions: There was no significant difference on incidence and mortality of COVID-19 between prior exposure to ICIs with other anti-tumor treatments. ICIs may reduce infection susceptibility of COVID-19 in metastatic cancer patients.

Keywords: COVID-19; Cancer; Immune checkpoint inhibitors; Meta-analyses.

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
Flow diagram of studies included into meta-analyses
Fig. 2
Fig. 2
Forest plot for assessing the incidence of COVID-19 infection in cancer patients previously treated with ICIs versus other anti-cancer treatments
Fig. 3
Fig. 3
Forest plot for assessing the incidence of COVID-19 infection in cancer patients previously treated with ICIs versus chemotherapy
Fig. 4
Fig. 4
Forest plot for assessing the incidence of COVID-19 infection in cancer patients previously treated with ICIs versus targeted therapy
Fig. 5
Fig. 5
Forest plot for assessing the mortality of COVID-19 infection in cancer patients previously treated with ICIs versus other anti-cancer treatments
Fig. 6
Fig. 6
Forest plot for assessing the mortality of COVID-19 infection in cancer patients previously treated with ICIs versus chemotherapy
Fig. 7
Fig. 7
Forest plot for assessing the mortality of COVID-19 infection in cancer patients previously treated with ICIs versus targeted therapy
See this image and copyright information in PMC

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