Risk Factors of Severe Events in COVID-19 Patients with Cancer: A Systematic Review and Meta-Analysis of Current Observational Studies

Abstract

Background: With the rising number of COVID-19 cases globally, cancer patients continue to be at a greater risk of infection when compared to the rest of the population. There may be certain risk factors that put this population at a higher risk for poor outcomes and prognosis. Therefore, we did a meta-analysis of retrospective studies aimed at determining the risk factors for severe events, defined as conditions requiring admission into an intensive care unit (ICU), use of mechanical ventilation or death in patients with cancer and COVID-19. Methods: We searched PubMed for studies of adults with confirmed COVID-19 infection. No language restrictions were applied. Data were independently extracted by two authors. All data points were independently checked by another author. The effect size was odds ratio (OR) and 95% confidence interval(95% CI). I2 was used to assess inter-study heterogeneity. Findings: A total of 6132 patients from 7 cohorts were included in the meta-analysis. Pooled results indicated that advanced age, male gender, stage IV cancer and comorbidity were risk factors for occurrence of severe events (OR 2.23,2.00, 2.76,2.95; 95% CI 1.58-3.15, 1.73-2.30,1.42-5.37,1.65-5.27; P= 0.05,0.68 and 0.43 respectively). Interpretation: Our findings suggest that advanced age, male gender, stage IV cancer and comorbidity are risk factors for severe events in patients with cancer and COVID-19. Funding Statement: The study was supported by Outstanding Youth Project of Henan Province Health Innovative Talents Project (YXKC2020028) and Middle-aged Leader Project of Henan Province Health (20208140051). Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: The study was registered with PROSPERO (CRD42020204689). Ethical approval and patient consent were not compulsory as this is a meta-analysis.