MO33-5 The impact of chemotherapy for cancer patients with COVID-19 on severity and mortality outcomes: A meta-analysis

Hariyanto, Timotius I.; Kurniawan, Andree

Background: Until now, the number of death cases from coronavirus disease 2019 (COVID-19) is still increasing. Several meta-analyses have shown that cancer is associated with poor outcomes from COVID-19. However, the decision of whether to continue or not cancer treatment in the current pandemic still give a dilemma. On one side, chemotherapy is meant to halt the progression of cancer and give a better prognosis, but on the other side, the compromised immune response caused by chemotherapy can increase the risk of infection and may worsen the course of infection. The results from various studies regarding the effects of recent cancer treatment, including chemotherapy on the COVID-19 course is still conflicting. This study aims to give clear evidence regarding the impact of chemotherapy treatment in cancer patients with COVID-19 infection on the severity and mortality outcomes. Methods: A systematic review was performed according to PRISMA guidelines. A literature search was conducted by two independent reviewers on all studies that included chemotherapy treatment in cancer patients who have COVID-19 infection using PubMed and PubMed Central databases. The outcome of interest included severe outcome and mortality rate. Statistical analysis was carried out using Review Manager 5.4 software. Results: A total of 3442 patients from 11 studies were included in our meta-analysis. Our meta-analysis showed that chemotherapy treatment in cancer patients with COVID-19 infection is not associated with severe outcome of COVID-19 [OR 1.04 (95% CI 0.82 - 1.31), p = 0.77, I2 = 17%, fixed-effect modelling] and mortality from COVID-19 infections [OR 1.18 (95% CI 0.81 - 1.72), p = 0.38, I2 = 41%, random-effect modelling]. Conclusion: Chemotherapy treatment on cancer patients with COVID-19 infections does not alter the severity and mortality outcomes from COVID-19. Physicians should continue the chemotherapy treatment for cancer patients despite the COVID-19 infection status.