Clinical Characteristics and Outcomes in Patients with COVID-19 and Cancer: a Systematic Review and Meta-analysis

Area of Science:

• Oncology
• Infectious Diseases
• Public Health

Background:

• Routine cancer care faced disruptions due to concerns about SARS-CoV-2 (coronavirus disease 2019) susceptibility in cancer patients.
• Understanding the impact of COVID-19 on cancer patients is crucial for informing clinical practice and public health policy.

Purpose of the Study:

• To systematically review the current evidence on the prevalence, presentation, and outcomes of COVID-19 in cancer patients.
• To inform policy and practice regarding the management of cancer patients during the COVID-19 pandemic.

Main Methods:

• A systematic literature search was conducted across major databases (PubMed, Cochrane, Embase, MedRxiv).
• Studies reporting primary data on COVID-19 in cancer patients were critically appraised using the NIH quality assessment tool.
• Random-effects meta-analyses were used to pool prevalence data and in-hospital mortality risk.

Main Results:

• 110 studies from 10 countries were included in the review.
• The pooled prevalence of cancer as a comorbidity in hospitalized COVID-19 patients was 2.6% globally (higher in Western countries: 5.6% vs. China: 1.7%).
• The pooled in-hospital mortality risk for cancer patients with COVID-19 was 14.1%. Common symptoms included fever, dyspnea, and chest tightness.

Conclusions:

• Available data corroborate an unfavorable outcome for hospitalized patients with both COVID-19 and cancer.
• Future studies should report detailed patient characteristics, including performance status, cancer type/stage, and prior anti-cancer treatments.
• Further research is needed to address impeding questions and refine evidence-based policy and practice.