The Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China.
Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China.
Int J Cancer. 2021 Jan 15;148(2):363-374. doi: 10.1002/ijc.33213. Epub 2020 Aug 15.
Evidence is mounting to indicate that cancer patients may have more likelihood of having coronavirus disease 2019 (COVID-19) but lack consistency. A robust estimate is urgently needed to convey appropriate information to the society and the public, in the time of ongoing COVID-19 pandemic. We performed a systematic review and meta-analysis through a comprehensive literature search in major databases in English and Chinese, and two investigators conducted publication selection and data extraction independently. A meta-analysis was used to obtain estimates of pooled prevalence of cancer in patients with COVID-19 and determine the association of cancer with severe events, after assessment of potential heterogeneity, publication bias, and correction for the estimates when necessary. Total 38 studies comprising 7094 patients with COVID-9 were included; the pooled prevalence of cancer was estimated at 2.3% (95% confidence limit [CL] [0.018, 0.029]; P < .001) overall and 3.2% (95% CL [0.023, 0.041]; P < .001) in Hubei province; the corresponding estimates were 1.4% and 1.9% after correction for publication bias; cancer was significantly associated with the events of severe cases (odds ratio [OR] = 2.20, 95% CL [1.53, 3.17]; P < .001) and death (OR = 2.97, 95% CL [1.48, 5.96]; P = .002) in patients with COVID-19, there was no significant heterogeneity and a minimal publication bias. We conclude that cancer comorbidity is associated with the risk and severe events of COVID-19; special measures should be taken for individuals with cancer.
越来越多的证据表明,癌症患者感染 2019 年冠状病毒病(COVID-19)的可能性更高,但缺乏一致性。在 COVID-19 持续流行的时期,迫切需要进行稳健的估计,以便向社会和公众传达适当的信息。我们通过在英文和中文的主要数据库中进行全面的文献搜索,进行了系统的综述和荟萃分析,两名调查人员独立进行了出版物选择和数据提取。使用荟萃分析来获得 COVID-19 患者中癌症的合并患病率估计值,并在评估潜在异质性、发表偏倚和必要时校正估计值后,确定癌症与严重事件的关联。总共纳入了 38 项研究,共包括 7094 名 COVID-9 患者;癌症的合并患病率总体估计为 2.3%(95%置信区间[CL] [0.018,0.029];P <.001),湖北省为 3.2%(95% CL [0.023,0.041];P <.001);在校正发表偏倚后,相应的估计值分别为 1.4%和 1.9%;癌症与 COVID-19 患者严重病例(优势比[OR] = 2.20,95% CL [1.53,3.17];P <.001)和死亡(OR = 2.97,95% CL [1.48,5.96];P =.002)事件显著相关,异质性无显著差异,发表偏倚较小。我们的结论是,癌症合并症与 COVID-19 的风险和严重事件相关;应针对癌症患者采取特殊措施。