Abstract
Cancer patients are vulnerable to complications of respiratory viruses. This systematic review and meta-analysis sought to examine the prevalence of cancer and its association with disease severity in patients with novel coronavirus disease 2019 (COVID-19). Searches were performed in MEDLINE, EMBASE and ScienceDirect from their inception until 28 April 2020. Severe disease was considered to encompass cases resulting in death or as defined by the primary study authors. Meta-analysis was performed using random-effect models. We included 20 studies involving 32,404 patients from China, the United Kingdom, the United States, Italy, Singapore, Thailand, France, India and South Korea. The pooled prevalence of cancer was 3.50% (95% confidence interval (CI) 1.70 to 5.80). The pooled prevalence was not moderated by study mean age, proportion of females or whether the study was conducted in/outside of China. Patients with cancer were more likely to experience severe COVID-19 disease compared to patients without cancer (pooled risk ratio 1.76, 95% CI 1.39 to 2.23). Our findings reiterate the need for additional precautionary measures to ensure that patients with cancer are not exposed to COVID-19, and if they become infected, extra attention should be provided to minimise their risk of adverse outcomes.
Highlights
The world is battling an immense threat from novel corona virus disease 2019 (COVID19)
Cancer patients may be more susceptible to COVID-19 than healthy individuals due to their high immunosuppressive burden caused by the cancer and anticancer treatments [4]
Across six studies involving 22,046 patients, those with cancer were more likely to experience severe disease compared to patients without cancer (pooled risk ratio (RRpooled) 1.76, 95% confidence intervals (CIs) 1.39 to 2.23, I2 = 20.9%) (Figure 3)
Summary
The world is battling an immense threat from novel corona virus disease 2019 (COVID19). A recent meta-analysis estimated that 2% of patients with COVID-19 had cancer [3]. The analysis included only data from China and did not evaluate the association of cancer with severe COVID-19 disease. Cancer patients may be more susceptible to COVID-19 than healthy individuals due to their high immunosuppressive burden caused by the cancer and anticancer treatments [4]. In this study, we aimed to estimate the prevalence of cancer among COVID-19-infected patients as well as ascertain the association between cancer and disease severity
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