Liu Qingchen, Wang Xia, Zhou Xueqin
People's Hospital of Fengjie, Chongqing, China.
Gynaecology, People's Hospital of Fengjie, Chongqing, China.
Front Oncol. 2025 Aug 6;15:1594617. doi: 10.3389/fonc.2025.1594617. eCollection 2025.
There are few clinical studies related to COVID-19 in pediatric cancer patients, and systematic reviews or meta-analyses on its mortality risk factors are particularly lacking. Therefore, we conducted this meta-analysis to systematically analyze the mortality risk factors of pediatric cancer patients after COVID-19 infection, providing effective evidence-based medical evidence for epidemic prevention and control and clinical treatment of pediatric COVID-19 patients.
Electronic databases of PubMed, Embase, Cochrane Library and Web of Science were searched using "cancer" "COVID-19" "children" "mortality" related subject headings and keywords. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Outcomes included age, weight, clinical complications in patients, cancer type, consolidation of cancer treatment, and critical illness. The quality of observational studies was assessed using the Newcastle-Ottawa Scale, which includes criteria such as study population selection, comparability, and evaluation of exposure or outcome, by two independent reviewers.
A computerized search of the literature yielded six observational studies with a total of 2,696 patients, and a pooled assessment of predictive factors revealed that the occurrence of adverse clinical complications, the presence of solid tumors, and the presence of acute and critical conditions significantly increased mortality in pediatric oncology patients (P < 0.05), although, overall, aggressive consolidation of cancer treatment significantly reduced the death of patients. Although overall,being in the cancer consolidation treatment period is significantly associated with a reduced risk of patient mortality, there is still an increase in mortality with Radiotherapy, possibly due to immunocompromise (P < 0.05), whereas Immunotherapy and Surgery do not affect patient prognosis. Subgroup analyses showed that prolonged consolidation of cancer treatment reduced mortality. The sensitivity analysis of the results of the outcome indicators was stable with low sensitivity and high confidence.
Adverse clinical complications, the presence of solid tumors, and the occurrence of critical conditions increase mortality in pediatric cancer patients. Receiving aggressive cancer treatment is associated with lower mortality rates, but this association should be interpreted with caution, as it may be confounded by other factors.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420250570932.
关于儿童癌症患者感染新型冠状病毒肺炎（COVID-19）的临床研究较少，尤其缺乏对其死亡风险因素的系统评价或荟萃分析。因此，我们进行了这项荟萃分析，以系统分析儿童癌症患者感染COVID-19后的死亡风险因素，为儿童COVID-19患者的疫情防控和临床治疗提供有效的循证医学依据。
使用“癌症”“COVID-19”“儿童”“死亡率”相关的主题词和关键词检索PubMed、Embase、Cochrane图书馆和Web of Science电子数据库。采用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。结局指标包括年龄、体重、患者临床并发症、癌症类型、癌症治疗巩固情况和危重症。由两名独立评审员使用纽卡斯尔-渥太华量表评估观察性研究的质量，该量表包括研究人群选择、可比性以及暴露或结局评估等标准。
计算机文献检索得到6项观察性研究，共2696例患者，对预测因素的汇总评估显示，不良临床并发症的发生、实体瘤的存在以及急性和危重症的存在显著增加了儿科肿瘤患者的死亡率（P<0.05），尽管总体而言，积极的癌症治疗巩固显著降低了患者的死亡。虽然总体而言，处于癌症巩固治疗期与患者死亡风险降低显著相关，但放疗仍会导致死亡率增加，可能是由于免疫功能低下（P<0.05），而免疫治疗和手术不影响患者预后。亚组分析显示，延长癌症治疗巩固期可降低死亡率。结局指标结果的敏感性分析稳定，敏感性低，可信度高。
不良临床并发症、实体瘤的存在以及危重症的发生会增加儿童癌症患者的死亡率。接受积极的癌症治疗与较低的死亡率相关，但这种关联应谨慎解读，因为它可能受到其他因素的混淆。
