People with cancer are at an increased risk of severe COVID-19 or death, a large meta-analysis confirms, with lung cancer and haematologic cancers conferring the highest risk. 

The systematic review and meta-analysis of 81 studies involving 61 532 patients found cancer was associated with an increased risk of severe COVID-19 or death compared with control patients (RR, 2.12). However, when patients were matched for age and sex, the risk decreased to an RR of 1.69.

Patients with lung cancer (RR 1.68), followed by those with haematologic cancer (RR 1.42), were at greatest risk of mortality from COVID-19 compared with patients with other cancers, the research team from the UK reported in their paper published in JAMA Open.

“The increased susceptibility to poor outcomes among patients with hematologic cancer is consistent with the more profound immune suppression that affects this patient group, whereas the increase in mortality among patients with lung cancer is likely associated with age, reduced lung reserve, comorbidities, and cancer treatment,” they wrote.

In line with other findings, younger age was associated with a worse clinical outcome than in the age-matched controls.

The review authors suggested that the finding could be explained by the type of cancer, intensity of treatment or behavioural factors such as increased social mixing compared to that of an older population.

When the authors looked at cancer treatments, chemotherapy was associated with the highest overall pooled case fatality rate of 30% and endocrine therapy was associated with the lowest at 11%. 

According to the authors, the latest statistics enables patients and their families to make informed decisions involving the risks of undergoing anticancer treatment during the pandemic and the degree to which they should limit social and familial interactions.