Hematol Oncol Stem Cell Ther. 2020 Jul 30:S1658-3876(20)30122-9. doi: 10.1016/j.hemonc.2020.07.005. Online ahead of print.
A number of studies have been published on outcomes of cancer patients infected with the SARS-CoV-2 virus causing the COVID-19 infection. However, most of these reports are single-center studies with a limited number of patients. To better assess the outcomes of this new infection in this subgroup of susceptible patients, we performed a systematic review and meta-analysis to evaluate the impact of COVID-19 infection on cancer patients. We searched PubMed, Web of Science, and Scopus for studies that reported the risk of infection and complications of COVID-19 in cancer patients. The literature search retrieved 22 studies (1018 cancer patients). The analysis showed that the frequency of cancer among COVID-19 confirmed patients was 2.1% (95% CI: 1.3%, 3%) in the overall cohort. These patients had a mortality of 21.1% (95% CI: 14.7%, 27.6%), severe/critical disease rate of 45.4% (95% CI: 37.4%, 53.3%), ICU admission rate of 14.5% (95% CI: 8.5%, 20.4%), and mechanical ventilation rate of 11.7% (95% CI: 5.5%, 18%). The double-arm analysis showed that cancer patients had higher risk of mortality (OR = 3.23, 95% CI: 1.71, 6.13), severe/critical disease (OR = 3.91, 95% CI: 2.70, 5.67), ICU admission (OR = 3.10, 95% CI: 1.85, 5.17), and mechanical ventilation (OR = 4.86, 95% CI: 1.27, 18.65), compared to non-cancer patients. Further, cancer patients had significantly lower platelet levels and a significantly higher D-dimer, C-reactive protein, and prothrombin time. In conclusion, these results indicate that cancer patients are at a higher risk of COVID-19 infection-related complications. Therefore, cancer patients need diligent preventive care measures and aggressive surveillance for earlier detection of COVID-19 infection.