Is Cancer an Independent Risk Factor for Fatal Outcomes of Coronavirus Disease 2019 Patients?

Xu, Jie; Xiao, Wenwei; Shi, Li; Wang, Yadong; Yang, Haiyan

BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by a novel virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has brought new challenges for global health systems. OBJECTIVE: The objective of this study was to investigate whether pre-diagnosed cancer was an independent risk factor for fatal outcomes of coronavirus disease 2019 (COVID-19) patients. METHOD: A comprehensive search was conducted in major databases of PubMed, Web of Science, and EMBASE to identify all published full-text studies as of January 20, 2021. Inter-study heterogeneity was assessed using Cochran's Q-statistic and I² test. A meta-analysis of random- or fixed-effects model was used to estimate the effect size. Publication bias, sensitivity analysis and subgroup analysis were also carried out. RESULTS: The confounders-adjusted pooled effects (pooled odds ratio [OR] = 1.47, 95% confidence interval [CI]: 1.31–1.65; pooled hazard ratio [HR] = 1.37, 95% CI: 1.21–1.54) indicated that COVID-19 patients with pre-diagnosed cancer were more likely to progress to fatal outcomes based on 96 articles with 6,518,992 COVID-19 patients. Further subgroup analyses by age, sample size, the proportion of males, region, study design and quality rating exhibited consistent findings with the overall effect size. CONCLUSION: Our analysis provides the objective findings based on the adjusted effect estimates that pre-diagnosed cancer is an independent risk factor for fatal outcome of COVID-19 patients. During the current COVID-19 pandemic, health workers should pay particular attention to cancer care for cancer patients and should prioritize cancer patients for vaccination.