Elsevier

European Journal of Cancer

Volume 141, December 2020, Pages 92-104
European Journal of Cancer

Review
A systematic review and meta-analysis: the effect of active cancer treatment on severity of COVID-19

https://doi.org/10.1016/j.ejca.2020.09.028Get rights and content

Highlights

  • Cancer treatment is challenging during COVID-19 pandemic.

  • Our knowledge has increased over the last three months particularly.

  • There are numerous studies; however, results were conflicting.

  • In this meta-analysis we showed that except chemotherapy there was no safety concern for cancer treatment during pandemic.

Abstract

Background

The COVID-19 pandemic hit all over the world, and cancer patients are more vulnerable for COVID-19. The mortality rate may increase up to 25% in solid malignancies. In parallel to increased mortality rates among cancer patients, safety concerns regarding cancer treatment has increased over time. However, there were contradictory results for the cancer treatment during pandemic. In this study, we assessed the effect of cancer treatment on the severity of COVID-19.

Methods

The MEDLINE database was searched on September 01, 2020. Primary end-points were severe disease and death in the cancer patients treated within the last 30 days before COVID-19 diagnosis. Quality of included studies was assessed by Newcastle–Ottawa scale. The generic inverse-variance method was used to calculate odds ratios (ORs) for each outcome.

Results

Sixteen studies were included for this meta-analysis. Chemotherapy within the last thirty days before COVID-19 diagnosis increased the risk of death in cancer patients after adjusting for confounding variables (OR: 1.85; 95% confidence interval: 1.26–2.71). However, severe COVID-19 risk did not increase. Furthermore, targeted therapies, immunotherapy, surgery and radiotherapy did not increase the severe disease and death risk in cancer patients with COVID-19.

Conclusion

Chemotherapy increased the risk of death from COVID-19 in cancer patients. However, there was no safety concern for immunotherapy, targeted therapies, surgery and radiotherapy.

Keywords

COVID-19
SARS-CoV-2
Cancer treatment
Chemotherapy
Immunotherapy
Targeted therapy

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