{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T20:56:00Z","timestamp":1789764960338,"version":"4.0.1"},"reference-count":77,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T00:00:00Z","timestamp":1644192000000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,12,24]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The COVID-19 has caused significant mortality and morbidity across the globe. Patients with cancer are especially vulnerable given their immunocompromised state. We aimed to determine the proportion of COVID-19 patients with cancer, their severity and mortality outcomes through a systematic review and meta-analysis (MA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Systematic review was performed through online databases, PubMed, Medline and Google Scholar, with keywords listed in the Methods section (1 November 2019\u201331 December 2020). Studies with clinical outcomes of at least 10 COVID-19 patients and at least one with a diagnosis of cancer were included. The studies for MA were assessed with PRISMA guidelines and appraised with Newcastle-Ottawa Scale. The data were pooled using a random-effects model using STATA software. The main outcomes were planned before data collection, including proportion of patients with cancer among COVID-19 populations, relative risk (RR) of severe outcomes and death of patients with cancer compared with general COVID-19 patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 57 case series (63 413 patients), with 230 patients with cancer with individual patient data (IPD). We found that the pooled proportion of cancer among COVID-19 patients was 0.04 (95% CI 0.03 to 0.05, I<jats:sup>2<\/jats:sup>=97.69%, p&lt;0.001). The pooled RR of death was 1.44 (95% CI 1.19 to 1.76) between patients with cancer and the general population with COVID-19 infection. The pooled RR of severe outcome was 1.49 (95% CI 1.18 to 1.87) between cancer and general COVID-19 patients. The presence of lung cancer and stage IV cancer did not result in significantly increased RR of severe outcome. Among the available IPD, only age and gender were associated with severe outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients with cancer were at a higher risk of severe and death outcomes from COVID-19 infection as compared with general COVID-19 populations. Limitations of this study include publication bias. A collaborative effort is required for a more complete database.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-044661","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T11:43:50Z","timestamp":1644234230000},"page":"e044661","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":52,"title":["Impact of cancer diagnoses on the outcomes of patients with COVID-19: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0217-7956","authenticated-orcid":false,"given":"Shuting","family":"Han","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, National Cancer Centre Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyuan","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianbang","family":"Chiang","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, National Cancer Centre Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sze Huey","family":"Tan","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Unit, National Cancer Centre Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail Wan Ying","family":"Chua","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, National Cancer Centre Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6623-9864","authenticated-orcid":false,"given":"Conghua","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Radiation and Medical Oncology, Wuhan University Zhongnan Hospital, Wuhan, Hubei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1648-1473","authenticated-orcid":false,"given":"Melvin L K","family":"Chua","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, National Cancer Centre Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Yang","family":"Soon","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National University Cancer Institute, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie Shiwen","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, National Cancer Centre Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,2,7]]},"reference":[{"key":"2025101814310508000_12.2.e044661.1","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-20-0422"},{"key":"2025101814310508000_12.2.e044661.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2648"},{"key":"2025101814310508000_12.2.e044661.3","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1016\/j.annonc.2020.04.006","article-title":"Do patients with cancer have a poorer prognosis of COVID-19? an experience in New York City","volume":"31","author":"Miyashita","year":"2020","journal-title":"Ann Oncol"},{"key":"2025101814310508000_12.2.e044661.4","doi-asserted-by":"crossref","DOI":"10.1177\/1758835920956803","article-title":"Outcomes of the 2019 novel coronavirus in patients with or without a history of cancer: a multi-centre North London experience","volume":"12","author":"Joharatnam-Hogan","year":"2020","journal-title":"Ther Adv Med Oncol"},{"key":"2025101814310508000_12.2.e044661.5","doi-asserted-by":"crossref","first-page":"3538","DOI":"10.1200\/JCO.20.01307","article-title":"Chemotherapy and COVID-19 outcomes in patients with cancer","volume":"38","author":"Jee","year":"2020","journal-title":"J Clin Oncol"},{"key":"2025101814310508000_12.2.e044661.6","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1080\/0284186X.2020.1837946","article-title":"Association of active oncologic treatment and risk of death in cancer patients with COVID-19: a systematic review and meta-analysis of patient data","volume":"60","author":"Park","year":"2021","journal-title":"Acta Oncol"},{"key":"2025101814310508000_12.2.e044661.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2020.09.028"},{"key":"2025101814310508000_12.2.e044661.8","doi-asserted-by":"crossref","unstructured":"Dai M , Liu D , Liu M , et al . 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