Risk of COVID-19 death for people with a pre-existing cancer diagnosis prior to COVID-19-vaccination: A systematic review and meta-analysis.
Int J Cancer
; 154(8): 1394-1412, 2024 Apr 15.
Article
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| MEDLINE
| ID: mdl-38083979
ABSTRACT
While previous reviews found a positive association between pre-existing cancer diagnosis and COVID-19-related death, most early studies did not distinguish long-term cancer survivors from those recently diagnosed/treated, nor adjust for important confounders including age. We aimed to consolidate higher-quality evidence on risk of COVID-19-related death for people with recent/active cancer (compared to people without) in the pre-COVID-19-vaccination period. We searched the WHO COVID-19 Global Research Database (20 December 2021), and Medline and Embase (10 May 2023). We included studies adjusting for age and sex, and providing details of cancer status. Risk-of-bias assessment was based on the Newcastle-Ottawa Scale. Pooled adjusted odds or risk ratios (aORs, aRRs) or hazard ratios (aHRs) and 95% confidence intervals (95% CIs) were calculated using generic inverse-variance random-effects models. Random-effects meta-regressions were used to assess associations between effect estimates and time since cancer diagnosis/treatment. Of 23 773 unique title/abstract records, 39 studies were eligible for inclusion (2 low, 17 moderate, 20 high risk of bias). Risk of COVID-19-related death was higher for people with active or recently diagnosed/treated cancer (general population aOR = 1.48, 95% CI 1.36-1.61, I2 = 0; people with COVID-19 aOR = 1.58, 95% CI 1.41-1.77, I2 = 0.58; inpatients with COVID-19 aOR = 1.66, 95% CI 1.34-2.06, I2 = 0.98). Risks were more elevated for lung (general population aOR = 3.4, 95% CI 2.4-4.7) and hematological cancers (general population aOR = 2.13, 95% CI 1.68-2.68, I2 = 0.43), and for metastatic cancers. Meta-regression suggested risk of COVID-19-related death decreased with time since diagnosis/treatment, for example, for any/solid cancers, fitted aOR = 1.55 (95% CI 1.37-1.75) at 1 year and aOR = 0.98 (95% CI 0.80-1.20) at 5 years post-cancer diagnosis/treatment. In conclusion, before COVID-19-vaccination, risk of COVID-19-related death was higher for people with recent cancer, with risk depending on cancer type and time since diagnosis/treatment.
Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
COVID-19
/
Neoplasias
Tipo de estudio:
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Int J Cancer
Año:
2024
Tipo del documento:
Article
País de afiliación:
Australia