Is Cancer an Independent Risk Factor for Fatal Outcomes of Coronavirus Disease 2019 Patients?

Background. Coronavirus disease 2019 (COVID-19), caused by a novel virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has brought new chal-lenges for global health systems. Objective. The objective of this study was to investigate whether pre-diagnosed cancer was an independent risk factor for fatal outcomes of coronavirus disease 2019 (COVID-19) patients. Method. A comprehensive search was conducted in major databases of PubMed, Web of Science, and EMBASE to identify all published full-text studies as of January 20, 2021. Inter-study heterogeneity was assessed using Cochran's Q-statistic and I 2 test. A meta-analysis of random-or fixed-effects model was used to estimate the effect size. Publication bias, sensitivity analysis and subgroup analysis were also carried out. Results. The confounders-adjusted pooled effects (pooled odds ratio [OR] = 1.47, 95% confidence interval [CI]: 1.31-1.65; pooled hazard ratio [HR] = 1.37, 95% CI: 1.21- 1.54) indicated that COVID-19 patients with pre-diagnosed cancer were more likely to progress to fatal outcomes based on 96 articles with 6,518,992 COVID-19 patients. Further subgroup analyses by age, sample size, the proportion of males, region, study design and quality rating exhibited consistent findings with the overall effect size. Conclusion. Our analysis provides the objective findings based on the adjusted effect estimates that pre-diagnosed cancer is an independent risk factor for fatal outcome of COVID-19 patients. During the current COVID-19 pandemic, health workers should pay particular attention to cancer care for cancer patients and should prioritize cancer patients for vaccination. (C) 2021 Instituto Mexicano del Seguro Social (IMSS). Published by Elsevier Inc. All rights reserved.