Mortality of COVID-19 in patients with hematological malignancies versus solid tumors: a systematic literature review and meta-analysis.

Autor: Hardy N; Nested Knowledge, Inc, St Paul, MN, USA., Vegivinti CTR; Department Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, New York, USA., Mehta M; Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India., Thurnham J; Nested Knowledge, Inc, St Paul, MN, USA., Mebane A; Superior Medical Experts, St. Paul, MN, USA., Pederson JM; Nested Knowledge, Inc, St Paul, MN, USA.; Superior Medical Experts, St. Paul, MN, USA., Tarchand R; Nested Knowledge, Inc, St Paul, MN, USA., Shivakumar J; Department of Internal Medicine, Montefiore Medical Center, Bronx, NY, USA., Olaniran P; Nested Knowledge, Inc, St Paul, MN, USA., Gadodia R; Medstar Washington Hospital Center/Georgetown University, Washington, DC, USA., Ganguly A; University of Texas Rio Grande Valley, Edinburg, TX, USA., Kelagere Y; Department of Pediatrics, Saint Peter's University Hospital, New Brunswick, NJ, USA., Nallabolu RR; UAB School of Dentistry, Birmingham, AL, USA., Gaddam M; The Brooklyn Hospital Center, Brooklyn, NY, USA., Keesari PR; Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India., Pulakurthi YS; Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India., Reddy R; Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India., Kallmes K; Nested Knowledge, Inc, St Paul, MN, USA., Musunuru TN; Department of Hematology/Oncology, University of Texas Medical Branch, Galveston, TX, USA. Tnmusunuru@mdanderson.org.
Jazyk: angličtina
Zdroj: Clinical and experimental medicine [Clin Exp Med] 2023 Oct; Vol. 23 (6), pp. 1945-1959. Date of Electronic Publication: 2023 Feb 16.
DOI: 10.1007/s10238-023-01004-5
Abstrakt: Cancer patients are more vulnerable to COVID-19 compared to the general population, but it remains unclear which types of cancer have the highest risk of COVID-19-related mortality. This study examines mortality rates for those with hematological malignancies (Hem) versus solid tumors (Tumor). PubMed and Embase were systematically searched for relevant articles using Nested Knowledge software (Nested Knowledge, St Paul, MN). Articles were eligible for inclusion if they reported mortality for Hem or Tumor patients with COVID-19. Articles were excluded if they were not published in English, non-clinical studies, had insufficient population/outcomes reporting, or were irrelevant. Baseline characteristics collected included age, sex, and comorbidities. Primary outcomes were all-cause and COVID-19-related in-hospital mortality. Secondary outcomes included rates of invasive mechanical ventilation (IMV) and intensive care unit (ICU) admission. Effect sizes from each study were computed as logarithmically transformed odds ratios (ORs) with random-effects, Mantel-Haenszel weighting. The between-study variance component of random-effects models was computed using restricted effects maximum likelihood estimation, and 95% confidence intervals (CIs) around pooled effect sizes were calculated using Hartung-Knapp adjustments. In total, 12,057 patients were included in the analysis, with 2,714 (22.5%) patients in the Hem group and 9,343 (77.5%) patients in the Tumor group. The overall unadjusted odds of all-cause mortality were 1.64 times higher in the Hem group compared to the Tumor group (95% CI: 1.30-2.09). This finding was consistent with multivariable models presented in moderate- and high-quality cohort studies, suggestive of a causal effect of cancer type on in-hospital mortality. Additionally, the Hem group had increased odds of COVID-19-related mortality compared to the Tumor group (OR = 1.86 [95% CI: 1.38-2.49]). There was no significant difference in odds of IMV or ICU admission between cancer groups (OR = 1.13 [95% CI: 0.64-2.00] and OR = 1.59 [95% CI: 0.95-2.66], respectively). Cancer is a serious comorbidity associated with severe outcomes in COVID-19 patients, with especially alarming mortality rates in patients with hematological malignancies, which are typically higher compared to patients with solid tumors. A meta-analysis of individual patient data is needed to better assess the impact of specific cancer types on patient outcomes and to identify optimal treatment strategies.
(© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Databáze: MEDLINE
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