Effect of cancer on outcome of COVID-19 patients: a systematic review and meta-analysis of studies of unvaccinated patients

  1. Giulia Di Felice
  2. Giovanni Visci  Is a corresponding author
  3. Federica Teglia
  4. Marco Angelini
  5. Paolo Boffetta  Is a corresponding author
  1. Department of Medical and Surgical Sciences, University of Bologna, Italy
  2. IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
  3. Stony Brook Cancer Center, Stony Brook University, United States
7 figures, 2 tables and 3 additional files

Figures

Flowchart for the identification of articles for the meta-analyses (PRISMA).
Forest plot – all types of cancer – outcome 1.
Forest plot – all types of cancer – outcome 2.
Forest plot – all types of cancer – outcome 3 or 4.
Funnel plot of Egger’s test to assess publication bias – all types of cancer – outcome 1.
Forest plot – all types of cancer – outcome 1 – reported versus calculated OR.
Figure 7 with 1 supplement
Forest plot – hematological neoplasms – outcome 1.
Figure 7β€”figure supplement 1
Forest plot – hematological neoplasms – outcome 2, 3, or 4.

Tables

Table 1
Selected characteristics of studies included in the meta-analysis – all cancers.
ReferencesCountryN patientsN outcomesQuality scoreComparisonOutcomeRR/OR*95% CI
Dai et al., 2020China6411059.25InternalMortality2.341.15–4.77
   ICU2.841.59–5.08
   Severity2.791.75–4.44
Haase et al., 2021Denmark3231511.5InternalMortality3.181.66–6.09
Meng et al., 2020China4361099.5InternalMortality2.98†1.76–5.05
Sun et al., 2020USA3236710.5InternalMortality5.67†1.49–21.58
   ICU1.91†0.90–4.06
   Hospitalization2.16†1.12–4.17
Nogueira et al., 2020Portugal20,2936119.25InternalMortality1.481.07–2.05
Zandkarimi et al., 2020Iran1831326.5InternalMortality3.571.82–7.02
Zhao et al., 2020China539236.5InternalMortality3.231.39–7.51
Harrison et al., 2020USA31,46119669.75InternalMortality0.87†0.72–1.09
Gupta et al., 2020USA22151127.5InternalMortality2.201.50–3.22
Ganatra et al., 2020USA24761959.25InternalMortality3.532.95–4.23
   Severity3.753.17–4.44
   Hospitalization2.782.37–3.26
Westblade et al., 2020USA22941008.5InternalMortality1.291.04–1.61
   Severity0.760.57–1.01
Wang et al., 2020USA16,570120011InternalMortality3.202.89–3.55
   Hospitalization2.852.63–3.09
Cherri et al., 2020Italy20395311InternalMortality2.22†1.25–3.94
GΓΆrgΓΌlΓΌ and Duyan, 2020Turkey4837511InternalMortality1.81†0.88–3.72
   ICU2.141.26–3.63
JimΓ©nez et al., 2020Spain15491039.75InternalMortality4.29†2.40–7.67
Thompson et al., 2020UK4708710InternalMortality2.20†1.27–3.81
Li et al., 2020China1859659ExternalMortality1.59†0.94–2.68
Shoumariyeh et al., 2020Germany78398.5ExternalMortality1.010.41–2.49
   Severity1.150.61–2.17
Mehta et al., 2020USA13082188.5ExternalMortality2.381.69–3.35
Rogado et al., 2020Spain42,495458ExternalMortality4.822.67–8.71
Brar et al., 2020USA5851179.5ExternalMortality0.980.58–1.66
   Severity0.800.57–1.13
Zhang et al., 2020bChina2171129.5ExternalMortality4.832.87–8.12
   ICU2.601.87–3.62
   Severity1.431.09–1.87
Sorouri et al., 2020Iran1595310ExternalMortality3.27†0.93–11.55
   ICU1.52†0.56–4.12
Lunski et al., 2021USA51453129.5ExternalMortality2.03†1.44–2.87
Atalla et al., 2021USA3392710.5InternalHospitalization3.341.81–6.16
Cheng et al., 2020China1476296InternalSeverity2.140.97–4.73
Song et al., 2021China961217InternalSeverity2.771.16–6.62
Liang et al., 2020China1590188.75InternalSeverity4.07†1.23–13.45
Bauer et al., 2021USA14491088.5InternalSeverity1.72†1.11–2.67
Tian et al., 2020China7512329ExternalSeverity3.752.71–5.19
  1. *

    Results derived from data reported in the publication are in italics.

  2. †

    Risk estimates derived from multivariate analysis.

  3. RR: Relative Risk; OR: Odds Ratio; CI: Confidence interval; ICU: Intensive Care Unit.

Table 2
Selected characteristics of studies included in the meta-analysis – hematological tumors.
Author – YearCountrySample size (n)Cancer (n)O number of cancer (%)Quality assessment (CASP)ComparisonOutcomeRR/OR*IC
Dai et al., 2020China64199.25InternalMortality9.072.16–38.13
Haase et al., 2021Denmark3231311.5InternalMortality1.830.85–3.93
Meng et al., 2020China327169.5InternalMortality2.83†0.96–8.32
Yigenoglu et al., 2021Turkey148074010.5ExternalMortality2.201.93–2.50
Shah et al., 2020UK1183689.75ExternalMortality1.74†1.12–2.71
Sanchez-Pina et al., 2020Spain923910.25ExternalMortality6.65†1.87–23.67
Passamonti et al., 2020Italy53611ExternalMortality2.04†1.77–2.35
Cattaneo et al., 2020Italy2041029ExternalMortality2.101.14–3.85
  1. *

    italics characters when calculated manually.

  2. †

    Risk estimates derived from multivariate analysis.

  3. CASP: Critical Appraisal Skills Programme; RR: Relative Risk; OR: Odds Ratio; IC: Interval Confidence; ICU: Intensive Care Unit.

Additional files

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