COVID-19 and Cancer: Lessons From a Pooled Meta-Analysis.

The coronavirus disease (COVID-19) pandemic continues, with more cases being reported in the United States over the last two weeks. The Centers for Disease Control and Prevention reports that most people in the United States will have little immediate risk of exposure to the virus. However, as in other infectious diseases, people with compromised immune systems are at increased risk for COVID-19, which includes the 15,338,988 people with cancer and many more cancer survivors. Recently, Liang et al reported a cancer prevalence of 1% (95% CI, 0.61% to 1.65%) among the 1,590 patient cases of COVID-19. This was higher compared with the overall cancer incidence of 0.29% in the Chinese population. More importantly, patients with cancer had a higher risk of severe events (a composite end point defined as the percentage of patients who were admitted to the intensive care unit and required invasive ventilation or who died) compared with those without cancer (39% v 8%; hazard ratio (39% v 8%, HR: 5.34; 95% CI, 1.80 to 16.18; P = .0026). However, their analysis was limited by the sample size (only 18 patients with cancer). Despite this, their analysis is hypothesis generating, especially given the fact that inflammation and cytokine-associated lung injury play important roles in COVID-19.