Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA.
Department of Radiation Oncology, Loyola University, Maywood, IL.
JNCI Cancer Spectr. 2021 Feb 24;5(2):pkaa102. doi: 10.1093/jncics/pkaa102. eCollection 2021 Apr.
Cancer patients with coronavirus disease 2019 (COVID-19) have been reported to have double the case fatality rate of the general population.
A systematic search of PubMed, Embase, and Cochrane Central was done for studies on cancer patients with COVID-19. Pooled proportions were calculated for categorical variables. Odds ratio (OR) and forest plots (random-effects model) were constructed for both primary and secondary outcomes.
This systematic review of 38 studies and meta-analysis of 181 323 patients from 26 studies included 23 736 cancer patients. Our meta-analysis shows that cancer patients with COVID-19 have a higher likelihood of death (n = 165 980, OR = 2.54, 95% confidence interval [CI] = 1.47 to 4.42), which was largely driven by mortality among patients in China. Cancer patients were more likely to be intubated. Among cancer subtypes, the mortality was highest in hematological malignancies (n = 878, OR = 2.39, 95% CI = 1.17 to 4.87) followed by lung cancer (n = 646, OR = 1.83, 95% CI = 1.00 to 3.37). There was no association between receipt of a particular type of oncologic therapy and mortality. Our study showed that cancer patients affected by COVID-19 are a decade older than the normal population and have a higher proportion of comorbidities. There was insufficient data to assess the association of COVID-19-directed therapy and survival outcomes in cancer patients.
Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity. A more nuanced understanding of the interaction between cancer-directed therapies and COVID-19-directed therapies is needed. This will require uniform prospective recording of data, possibly in multi-institutional registry databases.
患有 2019 年冠状病毒病（COVID-19）的癌症患者的病死率是普通人群的两倍。
对 PubMed、Embase 和 Cochrane Central 进行了系统检索，以查找关于患有 COVID-19 的癌症患者的研究。对分类变量计算了合并比例。主要和次要结局均构建了比值比（OR）和森林图（随机效应模型）。
这项对 38 项研究的系统综述和对 26 项研究中的 181323 例患者的荟萃分析纳入了 23736 例癌症患者。我们的荟萃分析表明，患有 COVID-19 的癌症患者死亡的可能性更高（n=165980，OR=2.54，95%置信区间[CI] = 1.47 至 4.42），这主要是由中国患者的死亡率驱动的。癌症患者更有可能被插管。在癌症亚型中，血液恶性肿瘤的死亡率最高（n=878，OR=2.39，95%CI=1.17 至 4.87），其次是肺癌（n=646，OR=1.83，95%CI=1.00 至 3.37）。接受特定类型的肿瘤治疗与死亡率之间没有关联。我们的研究表明，受 COVID-19 影响的癌症患者比普通人群年长十岁，且合并症的比例更高。由于数据不足，无法评估 COVID-19 定向治疗与癌症患者生存结局之间的关联。
患有 COVID-19 的癌症患者的死亡和发病风险增加。需要更细致地了解癌症定向治疗与 COVID-19 定向治疗之间的相互作用。这将需要统一的前瞻性数据记录，可能在多机构注册数据库中进行。
