Park Robin, Chidharla Anusha, Mehta Kathan, Sun Weijing, Wulff-Burchfield Elizabeth, Kasi Anup
Department of Medicine, MetroWest Medical Center/Tufts University School of Medicine, Framingham, MA, United States.
Department of Medicine, University of Illinois at Peoria, Peoria, Illinois, United States.
EClinicalMedicine. 2020 Sep;26:100519. doi: 10.1016/j.eclinm.2020.100519. Epub 2020 Aug 25.
Whether there is sex-bias within the adverse outcomes associated with COVID-19 in the cancer population is unknown. In this regard, several published studies have examined this question, but the results are inconclusive and inconsistent. To evaluate the sex-difference in the risk of adverse outcomes associated with COVID-19 in the cancer population, we have conducted a systematic review and meta-analysis.
Published articles evaluating adverse outcomes associated with COVID-19 in the cancer population from inception to June 2020 were identified by searching PubMed and EMBASE, ASCO 2020 Virtual Annual Conference, AACR 2020 COVID-19 and Cancer, ESMO conferences held from January to June 2020, and medRxiv and bioRxiv. Prospective or retrospective analyses in English, providing outcomes data with sex differences in the cancer population were included. The primary outcomes of interest were pooled ORs of severe illness, all-cause death, and the composite of severe illness and death attributable to COVID-19 in males versus females in cancer patients.
Overall, 3968 patients (17 studies) were analyzed in retrospective study settings. Overall, pooled ORs of the composite of severe illness and all-cause death in the setting of COVID-19 in males versus females was 1.60 (95% CI, 1.38-1.85). The risk of severe illness or death were both independently increased in males versus females.
Male sex was associated with a higher risk of severe illness and death attributable to COVID-19. This finding has implications in informing the clinical prognosis and decision making in the care of cancer patients.
This study received no funding.
癌症患者中与2019冠状病毒病（COVID-19）相关的不良结局是否存在性别差异尚不清楚。在这方面，已有多项发表的研究探讨了这个问题，但结果尚无定论且不一致。为了评估癌症患者中与COVID-19相关的不良结局风险的性别差异，我们进行了一项系统评价和荟萃分析。
通过检索PubMed、EMBASE、2020年美国临床肿瘤学会（ASCO）虚拟年会、2020年美国癌症研究协会（AACR）关于COVID-19与癌症的会议、2020年1月至6月举行的欧洲肿瘤内科学会（ESMO）会议以及medRxiv和bioRxiv，确定了从开始到2020年6月发表的评估癌症患者中与COVID-19相关不良结局的文章。纳入以英文发表的前瞻性或回顾性分析，这些分析提供了癌症患者中具有性别差异的结局数据。感兴趣的主要结局是癌症患者中男性与女性因COVID-19导致的重症、全因死亡以及重症和死亡综合结局的合并比值比（OR）。
总体而言，在回顾性研究中分析了3968例患者（17项研究）。总体而言，COVID-19情况下男性与女性重症和全因死亡综合结局指标的合并OR为1.60（95%置信区间[CI]，1.38 - 1.85）。男性与女性相比，重症或死亡风险均独立增加。
男性与因COVID-19导致的更高重症和死亡风险相关。这一发现对癌症患者的临床预后和护理决策具有指导意义。
本研究未获得资金支持。
