Influence of clinical characteristics and anti-cancer therapy on outcomes from SARS-CoV-2 infection: a systematic review and meta-analysis of 5,678 cancer patients

Background The COVID-19 pandemic started a healthcare crisis and heavily impacted cancer services. Methods Data from cohort studies of COVID-19 cancer patients published up until October 23rd 2020 from PubMed, PubMed Central, medRxiv and Google Scholar were reviewed. Meta-analyses using the random effects model was performed to assess the risk of death in cancer patients with COVID-19. Results Our meta-analyses including up to 5,678 patients from 13 studies showed that the following were all statistically significant risk factors for death following SARS-CoV-2 infection in cancer patients: age of 65 and above, presence of co-morbidities, cardiovascular disease, chronic lung disease, diabetes and hypertension. There was no evidence that patients who had received cancer treatment within 60 days of their COVID-19 diagnosis were at a higher risk of death, including patients who had recent chemotherapy. Conclusions Cancer patients are susceptible to severe COVID-19, especially older patients and patients with co-morbidities who will require close monitoring. Our findings support the continued administration of anti-cancer therapy during the pandemic. The analysis of chemotherapy was powered at 70% to detect an effect size of 1.2 but all other anti-cancer treatments had lower power. Further studies are required to better estimate their impact on the outcome of cancer patients.