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12-05-2022 | COVID-19 | News

Meta-analysis highlights increased COVID-19 mortality risk in cancer patients

Author: Laura Cowen

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medwireNews: Results of a large systematic review and meta-analysis show that people with cancer have a significantly greater risk for death from SARS-CoV-2 infection than their cancer-free peers, particularly if they have lung or hematologic cancer.

The analysis also revealed that “younger patients with cancer are a high-risk population for poor outcomes from COVID-19,” write Carlo Palmieri (University of Liverpool, UK) and co-authors in JAMA Network Open.

Just over half (52%) of the 58,849 participants of 81 case–control or cohort studies with demographic data available were men and the median age ranged from 35 to 74 years. The patients originated from 28 countries in five continents and were often hospitalized (55%).

The researchers found that the relative risk (RR) for death from COVID-19 was a significant 69% higher among patients with cancer than among age- and sex-matched controls without cancer.

In addition, regression analyses revealed that the RR for death in people with versus without cancer was greatest in the youngest participants and decreased with increasing age.

“To date, all of the cohort studies, which by their nature lacked an age-matched control group, have consistently reported increasing age as a risk factor for poor clinical outcome,” Palmieri et al remark.

They add: “Although it is true that older patients have worse absolute outcomes than younger patients, the RR data we found were highest for younger patients.”

Sex had no significant impact on COVID-19 mortality risk but pooled case fatality rates did vary by cancer type, ranging from 9% with breast cancer to 32% for hematologic cancer, as did the RRs.

Specifically, lung cancer and hematologic cancers were associated with significant 68% and 42% higher risks for death relative to other cancers, respectively, whereas breast cancer and gynecologic cancer were associated with significant 49% and 24% lower risks for death compared with controls.

Palmieri and team also observed that cancer treatment type had an impact on the course of SARS-CoV-2 infection, with pooled case fatality rates of 11%, 18%, 19%, 19%, 23%, and 30% for people who received endocrine therapy, targeted therapy, immunotherapy, surgery, radiotherapy, and chemotherapy, respectively.

The researchers say that “[o]ngoing studies such as the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterization Protocol UK will enable a more comprehensive comparison of patients with cancer vs control patients, with adjustments for age, sex, and other comorbidities, and the identification of the true risk of different tumor types and treatments while controlling for patient-level factors.”

They add that further “studies are needed that assess the outcome of mitigation and treatment measures over the course of the SARS-CoV-2 pandemic between patients with cancer and control patients given that many of the treatment studies did not recruit patients with cancer.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

12 May 2022: The coronavirus pandemic is affecting all healthcare professionals across the globe. Medicine Matters’ focus, in this difficult time, is the dissemination of the latest data to support you in your research and clinical practice, based on the scientific literature. We will update the information we provide on the site, as the data are published. However, please refer to your own professional and governmental guidelines for the latest guidance in your own country.

JAMA Netw Open 2022; 5: e2210880

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