BACKGROUND: Patients with cancer are at risk for severe COVID-19. Previous studies examining mortality in cancer patients with COVID-19 have produced inconclusive results. Several published meta-analyses have aimed to estimate this association, however, due to methodological limitations in study selection and data aggregation, do not reliably estimate the independent association between cancer and COVID-19 mortality. We conducted this systematic review and meta-analysis to determine whether cancer is an independent risk factor for COVID-19 mortality. METHODS: A literature search was performed in PubMed to identify studies that compared COVID-19 mortality in adult patients with and without cancer. Selection criteria included PCR-confirmed COVID-19, multivariate adjustment/matching for mortality risk estimates, and inclusion of hospitalized non-cancer controls. Adjusted odds ratios (OR) and/or hazard ratios (HR) for mortality based on cancer status were extracted. OR/HR estimates were pooled using a random effects model. RESULTS: The analysis included 42 studies comprising 129,840 patients: 8,612 cancer patients and 121,228 non-cancer controls. 18 studies showed a null difference in survival between cancer and non-cancer patients with COVID-19, and 24 studies showed statistically significantly worse survival in cancer patients with COVID-19. Meta-analysis revealed an increased risk of mortality in patients with cancer compared to non-cancer patients with COVID-19 (ORmeta = 1.93, 95% CI = 1.55-2.41, HRmeta = 1.54, 95% CI = 1.29-1.84). CONCLUSION: We conclude that cancer is an independent risk factor for mortality in unvaccinated patients admitted for or diagnosed with COVID-19 during hospitalization.
- All age groups
- Risk factor
- COVID-19
