Clinical risk factors for mortality in patients with cancer and COVID-19: a systematic review and meta-analysis of recent observational studies.

Liu, Yang; Lu, Huan; Wang, Wei; Liu, Qi; Zhu, Changju

INTRODUCTION Patients with cancer are more vulnerable to COVID-19 than the general population. Accordingly, it is necessary to identify the risk factors for death in patients with cancer and COVID-19. METHODS PubMed, Cochrane Library, and Embase Ovid databases were searched for relevant articles published before July 31st, 2020. Studies that explored the risk factors for mortality were included. The effect size was relative risk (RR) and 95% confidence interval (CI). RESULTS We included 17 observational studies involving 3268 patients. The pooled mortality was 24.8%. Male gender, age above 65 years, and comorbidities (especially hypertension and COPD) were risk factors for death (RR 1.16, 1.27, 1.12; 95% CI 0.7-1.95, 1.08-1.49, 1.04-1.2; P=0.006, 0.004 and 0.002, respectively). Recent anti-cancer treatments did not increase mortality (P> 0.05). Dyspnea, cough, and sputum were associated with an elevated risk of death (P< 0.05). Antibiotics, glucocorticoids, interferons, invasive ventilation, and complications were associated with a high probability of death (P< 0.05). CONCLUSIONS Various demographic and clinical characteristics, such as male gender, advanced age, comorbidities, and symptoms, were identified as risk factors for mortality in patients with cancer and COVID-19. Our findings suggest recent anti-cancer treatments do not increase mortality. TRIAL REGISTRATION Registration in PROSPERO (CRD42020201514).