Impact of the COVID-19 pandemic on head and neck cancer patients: systematic review and meta-analysis.

Abstract

This manuscript presents a systematic review of the impact of the COVID-19 pandemic on head and neck cancer (HNC) patients. A meta-analysis was made to compare the number of treated/operated HNC patients in pre-COVID-19 era (PCE) versus COVID-19 era (CE). This investigation is based on previous reports showing a delay in the diagnosis and treatment of new cases of cancer during the pandemic. Worsening in cancer prognosis would be expected as a result of the delayed treatments. An electronic search was conducted using the PubMed/MEDLINE, Embase, Web of Science, Scopus and The Cochrane Library databases. Relevant articles were selected based on specific inclusion criteria. A total of 8942 HNC patients were included. A higher prevalence in male (1873) in comparison to female (1695) was observed considering 3568 patients. Regarding staging, the majority of cases were stage III-IV. The treatment type more frequently described was surgery. Positive diagnosis for COVID-19 in the pre oncologic treatment was reported for 242 patients, and for post oncologic treatment in 119 patients. Mortality by COVID-19 was reported for 27 HNC patients. The meta-analysis revealed a significantly smaller number of surgeries/oncologic treatments of HNC patients performed (2666) in the CE when compared to PCE (3163) (M-H OR = 0.81, 95% CI = 0.65 to 1, P = 0.05). The impact of the COVID-19 pandemic on HNC patients occurred mainly in the number of surgeries/oncologic treatments, showing a significantly smaller number of surgeries/oncologic treatments performed in the CE rather than the PCE.