Department of Preventive Oncology, Institute of Health Sciences, Dokuz Eylul University, 15 July Medicine and Art Campus, Inciralti-Balcova, 35340, Izmir, Turkey.
Department of Translational Oncology, Institute of Oncology, Dokuz Eylul University, Izmir, Turkey.
Clin Exp Med. 2023 Oct;23(6):2221-2229. doi: 10.1007/s10238-022-00911-3. Epub 2022 Oct 7.
During the COVID-19 pandemic, cancer patients were among the most vulnerable patient groups to the SARS-CoV-2 infection effects. This paper aimed to conduct an umbrella review and meta-meta-analysis to determine the severity of disease in cancer patients affected by COVID-19. The umbrella review and meta-meta-analysis were undertaken according to the PRISMA and MOOSE guidelines. The PubMed/Medline, Web of Science, and Scopus databases were searched for published papers from the start of the pandemic through July 18, 2022. The pooled effect sizes (ES) and odds ratios (ORs) were calculated using a random effect model in the 95% confidence interval (CI) for ICU (Intensive Care Unit) admissions and mortality in cancer patients infected with SARS-CoV-2. Egger's linear regression test, schematic illustrations of funnel plots, and Begg and Mazumdar's rank correlation tests were used to quantify the possibility of publication bias. The pooled ES was calculated based on 1,031,783 participants, and mortality was significantly increased in cancer patients affected by COVID-19 (OR = 2.02, %95 CI: 1.74-2.35, p < 0.001). The pooled ES for ICU admission was also significantly increased in cancer patients infected with SARS-CoV-2 (OR = 1.84, %95 CI: 1.44-2.34, p < 0.001). As a result, this synthesis of systematic reviews and meta-analyses by the meta-meta-analysis method revealed that disease severity is higher in cancer patients affected by COVID-19. Since cancer patients are a more sensitive and specific patient group, they should be evaluated more carefully, especially during the COVID-19 pandemic and other pandemics that may occur in the future.
在 COVID-19 大流行期间，癌症患者是最易受到 SARS-CoV-2 感染影响的脆弱患者群体之一。本文旨在进行伞式审查和荟萃元分析，以确定 COVID-19 影响下癌症患者的疾病严重程度。伞式审查和荟萃元分析是根据 PRISMA 和 MOOSE 指南进行的。从大流行开始到 2022 年 7 月 18 日，在 PubMed/Medline、Web of Science 和 Scopus 数据库中搜索已发表的论文。使用随机效应模型在 95%置信区间 (CI) 中计算癌症患者感染 SARS-CoV-2 后 ICU (重症监护病房) 入院和死亡率的汇总效应大小 (ES) 和优势比 (OR)。Egger 线性回归检验、漏斗图示意图以及 Begg 和 Mazumdar 的秩相关检验用于量化发表偏倚的可能性。汇总 ES 基于 1,031,783 名参与者计算，COVID-19 影响下的癌症患者死亡率显著增加 (OR=2.02, %95 CI: 1.74-2.35, p<0.001)。癌症患者感染 SARS-CoV-2 后 ICU 入院的汇总 ES 也显著增加 (OR=1.84, %95 CI: 1.44-2.34, p<0.001)。因此，通过荟萃元分析方法对系统评价和荟萃分析进行综合分析表明，COVID-19 影响下的癌症患者疾病严重程度更高。由于癌症患者是一个更敏感和特定的患者群体，他们应该更仔细地评估，尤其是在 COVID-19 大流行和未来可能发生的其他大流行期间。
