scholarly journals A systematic review and meta-analysis of cancer patients affected by a novel coronavirus

2020 ◽  
Author(s):  
Bhanu Prasad Venkatesulu ◽  
Viveksandeep Thoguluva Chandrasekar ◽  
Prashanth Giridhar ◽  
Pragati Advani ◽  
Amrish Sharma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Odds Ratio ◽  
Normal Population ◽  
Meta Analysis ◽  
Case Fatality ◽  
Categorical Variables ◽  
Mortality And Morbidity ◽  
Cancer Subtypes ◽  
Increased Risk

Background Cancer patients with COVID-19 disease have been reported to have double the case fatality rate of the general population. Materials and methods A systematic search of PubMed/MEDLINE, Embase, Cochrane Central, Google Scholar, and MedRxiv was done for studies on cancer patients with COVID-19. Pooled proportions were calculated for categorical variables. Odds ratio and forest plots were constructed for both primary and secondary outcomes. The random-effects model was used to account for heterogeneity between studies. Results This systematic review of 31 studies and meta-analysis of 181,323 patients from 26 studies involving 23,736 cancer patients is the largest meta-analysis to the best of our knowledge assessing outcomes in cancer patients affected by COVID-19. Our meta-analysis shows that cancer patients with COVID-19 have a higher likelihood of death (odds ratio, OR 2.54), which was largely driven by mortality among patients in China. Cancer patients were more likely to be intubated, although ICU admission rates were not statistically significant. Among cancer subtypes, the mortality was highest in hematological malignancies (OR 2.43) followed by lung cancer (OR 1.8). There was no association between receipt of a particular type of oncologic therapy and mortality. Our study showed that cancer patients affected by COVID-19 are a decade older than the normal population and have a higher proportion of co-morbidities. There was insufficient data to assess the association of COVID-directed therapy and survival outcomes in cancer patients. Despite the heterogeneity of studies and inconsistencies in reported variables and outcomes, these data could guide clinical practice and oncologic care during this unprecedented global health pandemic. Conclusion Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity. A more nuanced understanding of the interaction between cancer-directed therapies and COVID-19-directed therapies is needed. This will require uniform prospective recording of data, possibly in multi-institutional registry databases.

scholarly journals A systematic review and meta-analysis of cancer patients affected by a novel coronavirus

2021 ◽  
Author(s):  
BhanuPrasad Venkatesulu ◽  
Viveksandeep Thoguluva Chandrasekar ◽  
Prashanth Girdhar ◽  
Pragati Advani ◽  
Amrish Sharma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Normal Population ◽  
Meta Analysis ◽  
Case Fatality ◽  
Categorical Variables ◽  
Mortality And Morbidity ◽  
Cancer Subtypes ◽  
Increased Risk ◽  
Novel Coronavirus

Abstract Background Cancer patients with COVID-19 disease have been reported to have double the case fatality rate of the general population. Methods A systematic search of PubMed, Embase, and Cochrane Central was done for studies on cancer patients with COVID-19. Pooled proportions were calculated for categorical variables. Odds ratio (OR) and forest plots (Random-effects model) were constructed for both primary and secondary outcomes.  Results This systematic review of 38 studies and meta-analysis of 181,323 patients from 26 studies included 23,736 cancer patients. Our meta-analysis shows that cancer patients with COVID-19 have a higher likelihood of death (n = 165,980, OR = 2.54, 95% confidence interval [CI] = 1.47 to 4.42), which was largely driven by mortality among patients in China. Cancer patients were more likely to be intubated. Among cancer subtypes, the mortality was highest in hematological malignancies (n = 878, OR = 2.39, 95% CI = 1.17 to 4.87) followed by lung cancer (n = 646, OR = 1.83, 95% CI = 1.00 to 3.37). There was no association between receipt of a particular type of oncologic therapy and mortality. Our study showed that cancer patients affected by COVID-19 are a decade older than the normal population and have a higher proportion of co-morbidities. There was insufficient data to assess the association of COVID-directed therapy and survival outcomes in cancer patients.  Conclusion Cancer patients with COVID-19 disease are at increased risk of mortality and morbidity. A more nuanced understanding of the interaction between cancer-directed therapies and COVID-19-directed therapies is needed. This will require uniform prospective recording of data, possibly in multi-institutional registry databases.

scholarly journals Mortality in Cancer Patients With COVID-19 Who Are Admitted to an ICU or Who Have Severe COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1286-1305
Author(s):  
Amogh Rajeev Nadkarni ◽  
Swapna C. Vijayakumaran ◽  
Sudeep Gupta ◽  
Jigeeshu V. Divatia
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Critically Ill ◽  
Odds Ratio ◽  
Hematologic Malignancy ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cancer Subtypes ◽  
Newcastle Ottawa Scale ◽  
Random Effects Modeling

PURPOSE There are scarce data to aid in prognostication of the outcome of critically ill cancer patients with COVID-19. In this systematic review and meta-analysis, we investigated the mortality of critically ill cancer patients with COVID-19. METHODS We searched online databases and manually searched for studies in English that reported on outcomes of adult cancer patients with COVID-19 admitted to an intensive care unit (ICU) or those with severe COVID-19 between December 2019 and October 2020. Risk of bias was assessed by the Modified Newcastle-Ottawa Scale. The primary outcome was all-cause mortality. We also determined the odds of death for cancer patients versus noncancer patients, as also outcomes by cancer subtypes, presence of recent anticancer therapy, and presence of one or more comorbidities. Random-effects modeling was used. RESULTS In 28 studies (1,276 patients), pooled mortality in cancer patients with COVID-19 admitted to an ICU was 60.2% (95% CI, 53.6 to 6.7; I2 = 80.27%), with four studies (7,259 patients) showing higher odds of dying in cancer versus noncancer patients (odds ratio 1.924; 95% CI, 1.596 to 2.320). In four studies (106 patients) of patients with cancer and severe COVID-19, pooled mortality was 59.4% (95% CI, –39.4 to 77.5; I2 = 72.28%); in one study, presence of hematologic malignancy was associated with significantly higher mortality compared with nonhematologic cancers (odds ratio 1.878; 95% CI, 1.171 to 3.012). Risk of bias was low. CONCLUSION Most studies were reported before the results of trials suggesting the benefit of dexamethasone and tocilizumab, potentially overestimating mortality. The observed mortality of 60% in cancer patients with COVID-19 admitted to the ICU is not prohibitively high, and admission to the ICU should be considered for selected patients (registered with PROSPERO, CRD42020207209).

scholarly journals Psychosis in children of separated parents: A systematic review and meta-analysis

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Luis Ayerbe ◽  
María Pérez-Piñar ◽  
Quintí Foguet-Boreu ◽  
Salma Ayis
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Psychotic Disorders ◽  
Meta Analysis ◽  
Childhood Adversity ◽  
Case Control ◽  
Parental Separation ◽  
Cross Sectional ◽  
Increased Risk ◽  
Cross Sectional Studies

Abstract Background. Parental separation is a very common childhood adversity. The association between other adverse childhood experiences and an increased risk of psychosis has been reported. However, the evidence on the risk of psychosis for children of separated parents is limited. In this systematic review, cohort, case–control, and cross-sectional studies, comparing the risk of psychotic disorders for people with and without separated parents, were searched, critically appraised, and summarized. Methods. Studies were searched in PubMed, EMBASE, PsycINFO, and the Web of Science, from database inception to September 2019. A meta-analysis, using random-effects models, was undertaken to obtain pooled estimates of the risk of psychosis among participants with separated parents. Results. Twelve studies, with 305,652 participants from 22 countries, were included in the review. A significantly increased risk of psychosis for those with separated parents was observed, with a pooled odds ratio: 1.53 (95% confidence interval [CI]: 1.29–1.76), p < 0.001. The association remained significant when cohort, case–control, and cross-sectional studies were analyzed separately. The five cohort studies included in this review showed and increased risk of psychosis with odds ratio: 1.47 (95% CI: 1.26–1.69), p < 0.001. Conclusions. Parental separation is a common childhood adversity associated with an increased risk of psychosis. Although the risk for an individual child of separated parents is still low, given the high proportion of couple that separate, the increased rates of psychosis may be substantial in the population. Further studies on the risk of psychosis in those with separated parents, and the explanatory factors for this association, are required.

scholarly journals Clinical Characteristics and Outcomes of COVID-19–Infected Cancer Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Hua Zhang ◽  
Han Han ◽  
Tianhui He ◽  
Kristen E Labbe ◽  
Adrian V Hernandez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
Patients With Cancer ◽  
Increased Risk

Abstract Background Previous studies have indicated coronavirus disease 2019 (COVID-19) patients with cancer have a high fatality rate. Methods We conducted a systematic review of studies that reported fatalities in COVID-19 patients with cancer. A comprehensive meta-analysis that assessed the overall case fatality rate and associated risk factors was performed. Using individual patient data, univariate and multivariable logistic regression analyses were used to estimate odds ratios (OR) for each variable with outcomes. Results We included 15 studies with 3019 patients, of which 1628 were men; 41.0% were from the United Kingdom and Europe, followed by the United States and Canada (35.7%), and Asia (China, 23.3%). The overall case fatality rate of COVID-19 patients with cancer measured 22.4% (95% confidence interval [CI] = 17.3% to 28.0%). Univariate analysis revealed age (OR = 3.57, 95% CI = 1.80 to 7.06), male sex (OR = 2.10, 95% CI = 1.07 to 4.13), and comorbidity (OR = 2.00, 95% CI = 1.04 to 3.85) were associated with increased risk of severe events (defined as the individuals being admitted to the intensive care unit, or requiring invasive ventilation, or death). In multivariable analysis, only age greater than 65 years (OR = 3.16, 95% CI = 1.45 to 6.88) and being male (OR = 2.29, 95% CI = 1.07 to 4.87) were associated with increased risk of severe events. Conclusions Our analysis demonstrated that COVID-19 patients with cancer have a higher fatality rate compared with that of COVID-19 patients without cancer. Age and sex appear to be risk factors associated with a poorer prognosis.

P960Association of peri-procedural intravenous morphine use on clinical outcomes in ST-elevation myocardial infarction treated by percutaneous coronary intervention: systematic review and meta-analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Batchelor ◽  
D Liu ◽  
J Bloom ◽  
S Noaman ◽  
W Chan
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Percutaneous Coronary Intervention ◽  
Clinical Outcomes ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
St Elevation

Abstract Background Morphine analgesia may affect absorption of co-prescribed P2Y12 antagonists attenuating platelet inhibition. The impact of peri-procedural intravenous (IV) morphine administration on clinical outcomes in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI) is not well defined. Purpose To conduct a systematic review and meta-analysis exploring clinical outcomes with peri-procedural IV morphine in patients undergoing PPCI for STEMI. Methods Analysis of the electronic databases MEDLINE, EMBASE, CENTRAL, Scopus, Web of Science and ClinicalTrials.gov for association of peri-PCI IV morphine use with myocardial infarction (MI) and mortality. Primary and secondary outcomes were in-hospital or 30-day MI and all-cause mortality respectively. Results Eleven studies (1 randomised controlled trial; 10 cohort studies) were included for systematic review. Five studies, including 3,748 patients were included in meta-analysis of the primary outcome. Of 3,748 patients, 2,239 were treated concurrently with ticagrelor, 1,256 treated with clopidogrel and 253 with prasugrel. As shown in the Figure, there was a trend towards increased risk of myocardial infarction with IV morphine (odds ratio 1.88; 95% CI 0.87–4.09, I2 0%). Across seven studies and 6585 patients, no increased risk of mortality at the same composite time endpoint was evident (odds ratio 0.70, 95% CI 0.40–1.23, I2 19%). Figure 1. MI in hospital or at 30 days Conclusion Based on current literature, evidence of an association between IV morphine and myocardial infarction in patients undergoing PPCI for STEMI is limited by observational methodology and conflicting results. There is no evidence of an association between intravenous peri-procedural morphine and mortality. Clinical trial evidence with strong documentation of adverse events data is required to demonstrate association or causality. Acknowledgement/Funding None

PROGNOSIS OF DIFFERENTIATED THYROID CARCINOMA IN PATIENTS WITH GRAVES DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

2019 ◽  
Vol 25 (12) ◽  
pp. 1323-1337 ◽  
Author(s):  
Poemlarp Mekraksakit ◽  
Pattara Rattanawong ◽  
Rudruidee Karnchanasorn ◽  
Chanavuth Kanitsoraphan ◽  
Natnicha Leelaviwat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Thyroid Carcinoma ◽  
Cancer Diagnosis ◽  
Distant Metastasis ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Differentiated Thyroid Carcinoma ◽  
Graves Disease ◽  
Increased Risk

Objective: It is still controversial whether differentiated thyroid carcinoma (DTC) in patients with Graves disease (GD) can be more aggressive than non-Graves DTC. We conducted a systematic review and meta-analysis to examine the association between GD and prognosis in patients with DTC. Methods: We comprehensively searched the databases of MEDLINE and EMBASE from inception to March 2019. We included published studies that compared the risk of mortality and prognosis between DTC patients with GD and those with non-GD. Data from each study were combined using the random-effects model. Results: Twenty-five studies from February 1988 to May 2018 were included (987 DTC patients with GD and 2,064 non-Graves DTC patients). The DTC patients with GD had a significantly higher risk of associated multifocality/multicentricity (odds ratio, 1.45; 95% confidence interval, 1.04 to 2.02; I 2, 6.5%; P = .381) and distant metastasis at the time of cancer diagnosis (odds ratio, 2.19; 95% confidence interval, 1.08 to 4.47; I 2, 0.0%; P = .497), but this was not associated with DTC-related mortality and recurrence/persistence during follow-up. Conclusion: Our meta-analysis demonstrates a statistically significant increased risk of multifocality/multicentricity and distant metastasis at the time of cancer diagnosis in DTC patients with GD than those without GD. Abbreviations: CI = confidence interval; DTC = differentiated thyroid carcinoma; GD = Graves disease; LN = lymph node; OR = odds ratio; PTC = papillary thyroid carcinoma; TC = thyroid carcinoma; TSAb = thyroid-stimulating antibody; TSH = thyroid-stimulating hormone

scholarly journals Association between Hidradenitis Suppurativa and Inflammatory Arthritis: A Systematic Review and Meta-Analysis

Dermatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Nouf Almuhanna ◽  
Alexandra Finstad ◽  
Raed Alhusayen
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Ankylosing Spondylitis ◽  
Odds Ratio ◽  
Inflammatory Arthritis ◽  
Hidradenitis Suppurativa ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Increased Risk ◽  
High Prevalence

<b><i>Background:</i></b> Several studies report a high prevalence of inflammatory arthritis among hidradenitis suppurativa (HS) patients. <b><i>Objectives:</i></b> To study the association between HS and inflammatory arthritis. <b><i>Methods:</i></b> The systematic review and meta-analysis were performed according to the PRISMA guidelines to identify the association between HS and inflammatory arthritis, spondyloarthritis, ankylosing spondylitis (AS), and rheumatoid arthritis (RA). <b><i>Results:</i></b> Seven studies were entered in the analysis, with 200,361 HS patients and 385,599 controls. Pooled analysis illustrated a significantly increased risk of inflammatory arthritis in HS patients compared to controls (odds ratio [OR] 3.44; 95% confidence interval [CI] 1.92–6.17). There was also a statistically significant association between HS and spondyloarthritis (OR 2.10; 95% CI 1.40–3.15), and between HS and AS (OR 1.89; 95% CI 1.14–3.12). Moreover, pooled analysis showed a statistically significant association between HS and RA (OR 1.96; 95% CI 1.28–2.98). <b><i>Conclusions:</i></b> Our findings show that HS patients have a 3-fold increased risk of developing inflammatory arthritis. HS patients are specifically at a higher risk for spondyloarthritis, its subtype AS, and RA.

scholarly journals Elevated D-Dimer Levels are Associated with Increased Risk of Mortality in COVID-19: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Siddharth Shah ◽  
Kuldeep Shah ◽  
Siddharth B Patel ◽  
Forum S Patel ◽  
Mohammed Osman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Severe Disease ◽  
Case Fatality ◽  
Inclusion Criteria ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Novel Coronavirus ◽  
D Dimer

AbstractIntroductionThe 2019 novel Coronavirus (2019-nCoV), now declared a pandemic has an overall case fatality of 2–3% but it is as high as 50% in critically ill patients. D-dimer is an important prognostic tool, often elevated in patients with severe COVID-19 infection and in those who suffered death. In this systematic review, we aimed to investigate the prognostic role of D-dimer in COVID-19 infected patients.MethodsWe searched PubMed, Medline, Embase, Ovid, and Cochrane for studies reporting admission D-dimer levels in COVID-19 patients and its effect on mortality.Results18 studies (16 retrospective and 2 prospective) with a total of 3,682 patients met the inclusion criteria. The pooled mean difference (MD) suggested significantly elevated D-dimer levels in patients who died versus those survived (MD 6.13 mg/L, 95% CI 4.16 − 8.11, p <0.001). Similarly, the pooled mean D-dimer levels were significantly elevated in patients with severe COVID-19 infection (MD 0.54 mg/L, 95% CI 0.28 − 0.8, p< 0.001). In addition, the risk of mortality was four-fold higher in patients with positive D-dimer vs negative D-dimer (RR 4.11, 95% CI 2.48 − 6.84, p< 0.001) and the risk of developing the severe disease was two-fold higher in patients with positive D-dimer levels vs negative D-dimer (RR 2.04, 95% CI 1.34 − 3.11, p < 0.001).ConclusionOur meta-analysis demonstrates that patients with COVID-19 presenting with elevated D-dimer levels have an increased risk of severe disease and mortality.

scholarly journals A comprehensive systematic review and meta-analysis of the global data involving 61,532 cancer patients with SARS-CoV-2 infection.

2021 ◽  
Author(s):  
Emma Khoury ◽  
Sarah Nevitt ◽  
William Rohde Madsen ◽  
Lance Turtle ◽  
Gerry Davies ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Malignant Disease ◽  
Meta Analysis ◽  
Severe Disease ◽  
Cancer Control ◽  
Haematological Malignancies ◽  
Cancer Treatments ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background SARS-CoV-2 have been shown to be associated with more severe disease and death in cancer patient. A systematic review and meta-analysis was conducted to determine the risk by age, tumour type and treatment of infection with SARS-CoV-2 in cancer patients. Methods Systematic review by searching PubMed, Web of Science, and Scopus for articles published in English up to June 14, 2021 of SARS-CoV-2 infection in >10 patients with malignant disease. Outcomes included factors in patients with malignant disease that may predict a poor outcome from COVID-19 compared to patients without malignant disease, including patient demographics, tumour subtype and cancer treatments. A meta-analysis was performed using random effects model. Results 81 studies were included, totalling 61,532 cancer patients. Haematological malignancies comprised 22.1% (9,672 of 43,676) of cases. Relative risk (RR) of mortality when age and sex matched was 1.69 (95% CI, 1.46-1.95; p<0.001; I2=51%). RR of mortality, versus non-cancer patients, was associated with decreasing age (exp(b)0.96; 95% CI, 0.922-0.994; p=0.028) but not male sex (exp(b)1.89; 95% CI, 0.222-6.366; p=0.83). RR of mortality in those with haematological malignancies versus non-cancer control was 1.81 (95% CI, 1.53-2.95; I2=0.0%). Compared to other cancers, increased risk of death was seen for lung (RR 1.68, 95% CI, 1.45-1.94; p<0.001), genitourinary (RR 1.11; 95% CI, 1.00-1.24; p=0.059) and haematological malignancies (RR 1.42; 95% CI, 1.31-1.54; p<0.001). Breast (RR 0.51; 95% CI, 0.36-0.71; p<0.001) and gynaecological cancers (RR 0.76; 95% CI, 0.62-0.93; p=0.009) had lower risk of death. Receipt of chemotherapy had greatest overall pooled mortality risk of 30% (95% CI, 25-36%; I2=86.97%) and endocrine therapy the lowest at 11% (95% CI, 6-16%; I2=70.7%). Conclusions Cancer patients, particularly younger cancer patients, appear at increased risk of mortality from COVID-19 compared to non-cancer patients. Differences in outcomes were seen based on tumour types and treatment.

scholarly journals High parity is associated with increased risk of cervical cancer: Systematic review and meta-analysis of case-control studies

2021 ◽  
Author(s):  
Yohannes Tekalegn ◽  
Biniyam Sahiledengle ◽  
Demelash Woldeyohannes ◽  
Daniel Atlaw ◽  
Fikreab Desta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Random Effect ◽  
Epidemiological Studies ◽  
Analysis Model ◽  
Case Control Studies ◽  
High Parity ◽  
Increased Risk

Abstract Background: Cervical cancer is the fourth most common cancer among women. High parity has long been suspected with an increased risk of cervical cancer. Evidence from the existing epidemiological studies regarding the association between parity and cervical cancer is variable and inconsistent. Therefore, the objective of this systematic review and meta-analysis was to synthesize the best available evidence on the epidemiological association between parity and cervical cancer. Methods: MEDLINE/PubMed, HINARI, Google scholar, Science direct, and Cochrane Libraries were systematically searched. Cochrane Q statistics and I2 tests were performed to assess heterogeneity among included studies. Begg's test and egger's regression analysis were performed to assess publication bias. A random-effect meta-analysis model was used to compute pooled odds ratio of the association between parity and cervical cancer. Results: A total of 6975 participants (1998 patients; 4977 controls) were incorporated in the 13 articles included in the final meta-analysis. The meta-analysis revealed that women with parity greater than or equal to three had 2.4 times higher odds of developing cervical cancer compared to women with parity less than three [pooled odds ratio (POR) = 2.4, 95% CI: 1.9-3.2]. Conclusion: High parity is associated with an increased risk of cervical cancer. Strong epidemiological studies are recommended to further explore the mechanisms and role of parity in the causation of cervical cancer.

Sign in / Sign up

Export Citation Format

Share Document