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This systematic review and pooled analysis is intended to provide an improved estimate of the mortality among cancer patients with COVID-19. Previous studies have indicated mortality rates ranging from 3.7% to 61.5%. This analysis gives a pooled odds ratio for mortality of 25.6%.
The authors conclude that increased risk of death from COVID-19 in cancer patients is an independent factor necessitating aggressive preventive measures and optimal management if infection is contracted. Additional reviews would further define subsets of cancer patients at greatest risk.
– Emily Miller, MD
The publisher has made this article available for free until 10/13/2020 12:00:00 AM .
Patients with COVID-19 who have underlying malignancy have a higher mortality rate compared with those without cancer, although the magnitude of such excess risk is not clearly defined. We performed a systematic review and pooled analysis to provide precise estimates of the mortality rate among patients with both cancer and COVID-19.
A systematic literature search involving peer reviewed publications, preprints, and conference proceedings up to July 16, 2020 was performed. The primary endpoint was the case fatality rate (CFR), defined as rate of death among patients with cancer and COVID-19. The CFR was assessed with a random effects model, which was used to derive a pooled CFR and its 95% confidence interval (CI).
52 studies, involving a total of 18,650 patients with both COVID-19 and cancer were selected for the pooled analysis. A total of 4,243 deaths were recorded in this population. The probability of death was 25·6% (95% CI 22·0% to 29·9%; I2=48·9%) in this patient population.
Patients with cancer who develop COVID-19 have high probability of mortality. Appropriate and aggressive preventive measures must be taken to reduce the risk of COVID-19 in patients with cancer, and to optimally manage those who do contract the infection.