Effect of antitumor therapy on cancer patients infected by SARS-CoV-2: A systematic review and meta-analysis

Background: Cancer patients are at a high risk of being infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and are more likely to develop severe illness and have higher mortality once infected. In the COVID-19 pandemic, it is urgent to understand the effects of antitumor therapy on the prognosis of patients with COVID-19.

Methods: A systematic literature search was conducted in PubMed, Cochrane Library, Embase, MedRxiv, and Chinese National Knowledge Infrastructure (CNKI) until 21 June 2020. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were evaluated using a random effects model to analyze the effects of antitumor therapies on COVID-19 patients.

Results: For cancer patients with COVID-19, the death events related to antitumor treatment were higher than those with no antitumor treatment (OR = 1.55; 95% CI 1.07-2.25; p = 0.021). Compared with patients in the survival group, the non-survival group showed no significant differences in patients who received antitumor therapy. Compared with patients in the non-severe group, the severe group was more likely to receive antitumor therapy (OR = 1.50; 95% CI 1.02-2.19; p = 0.037) and there was a significant difference. The incidence of severe events was higher in the subgroup of chemotherapy (OR = 1.73; 95% CI 1.09-2.73).

Conclusion: The synthesized evidence suggests that cancer patients with COVID-19 who received antitumor treatment shortly before symptom onset are more likely to experience severe symptoms and have high mortality. Receiving chemotherapy is an unfavorable factor for the prognosis of cancer patients with COVID-19.