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SARS-CoV-2 感染对癌症患者死亡率、入住 ICU 率和发病率的影响:一项涉及 709908 名参与者和 31732 例癌症患者的系统评价和荟萃分析。

Effects of SARS-CoV-2 infections in patients with cancer on mortality, ICU admission and incidence: a systematic review with meta-analysis involving 709,908 participants and 31,732 cancer patients.

机构信息

Department of Preventive Oncology, Institute of Health Sciences, Dokuz Eylul University, 15 July Medicine and Art Campus, Inciralti-Balcova 35340, Izmir, Turkey.

Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

出版信息

J Cancer Res Clin Oncol. 2023 Jul;149(7):2915-2928. doi: 10.1007/s00432-022-04191-y. Epub 2022 Jul 13.

Abstract

BACKGROUND

Cancer patients constitute one of the highest-risk patient groups during the COVID-19 pandemic. In this study, it was aimed to perform a systematic review and meta-analysis to determine both the incidence and ICU (Intensive Care Unit) admission rates and mortality in SARS-CoV-2 infected cancer patients.

METHODS

The PRISMA guidelines were closely followed during the design, analysis, and reporting of this systematic review and meta-analysis. A comprehensive literature search was performed for the published papers in PubMed/Medline, Scopus, medRxiv, Embase, and Web of Science (WoS) databases. SARS-CoV-2 infection pooled incidence in the cancer populations and the risk ratio (RR) of ICU admission rates/mortality in cancer and non-cancer groups, with 95% confidence intervals (CIs), were calculated using the random-effects model.

RESULTS

A total of 58 studies, involving 709,908 participants and 31,732 cancer patients, were included in this study. The incidence in cancer patients was calculated as 8% (95% CI: 8-9%). Analysis results showed that mortality and ICU admission rate was significantly higher in patients with cancer (RR = 2.26, 95% CI: 1.94-2.62, P < 0.001; RR = 1.45, 95% CI: 1.28-1.64, p < 0.001, respectively).

CONCLUSION

As a result, cancer was an important comorbidity and risk factor for all SARS-CoV-2 infected patients. This infection could result in severe and even fatal events in cancer patients. Cancer is associated with a poor prognosis in the COVID-19 pandemic. Cancer patients should be assessed more sensitively in the COVID-19 outbreak.

摘要

背景

癌症患者是 COVID-19 大流行期间风险最高的患者群体之一。本研究旨在进行系统评价和荟萃分析,以确定 SARS-CoV-2 感染癌症患者的发病率和 ICU(重症监护病房)入住率及死亡率。

方法

本系统评价和荟萃分析的设计、分析和报告严格遵循 PRISMA 指南。在 PubMed/Medline、Scopus、medRxiv、Embase 和 Web of Science(WoS)数据库中对已发表的论文进行了全面的文献检索。使用随机效应模型计算癌症人群中 SARS-CoV-2 感染的合并发病率和癌症与非癌症组 ICU 入住率/死亡率的风险比(RR)及其 95%置信区间(CI)。

结果

本研究共纳入 58 项研究,涉及 709908 名参与者和 31732 名癌症患者。癌症患者的发病率计算为 8%(95%CI:8-9%)。分析结果显示,癌症患者的死亡率和 ICU 入住率显著更高(RR=2.26,95%CI:1.94-2.62,P<0.001;RR=1.45,95%CI:1.28-1.64,p<0.001)。

结论

因此,癌症是所有 SARS-CoV-2 感染患者的重要合并症和危险因素。这种感染可能导致癌症患者发生严重甚至致命的事件。癌症与 COVID-19 大流行中的不良预后相关。在 COVID-19 疫情期间,应更敏感地评估癌症患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2b4/11797184/55f7df449b8d/432_2022_4191_Fig1_HTML.jpg

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