medwireNews: Men with cancer and SARS-CoV-2 infection may have an increased risk for a severe disease course and death attributable to COVID-19, suggests a systematic review and meta-analysis.
“This finding may help guide […] decision making in oncologic care and patient counselling in the clinic especially as societies move towards re-opening and towards a new-normal,” comment Anup Kasi (Kansas University Medical Center, Kansas City, USA) and co-authors.
They explain that “the epidemiological association of sex with adverse outcomes associated with COVID-19 appears to be established in the general community population,” but in light of “conflicting and inconclusive” findings from recent studies, such an association in the cancer patient population remains to be confirmed.
The team therefore conducted a meta-analysis of 17 retrospective studies – comprising a total of 3968 patients with cancer and COVID-19 – that provided data on COVID-19 outcomes by sex. The studies were reported in a scientific journal, at a conference, or as a preprint; the majority (n=10) were conducted in China, while three were from USA, two were multinational collaborations, and one each were from France and the UK.
As reported in in EClinicalMedicine, male patients had a significantly increased risk for the composite outcome of severe illness or death relative to female patients, with a pooled odds ratio (OR) of 1.60 in univariate analysis. This was also the case for the individual endpoints, with a pooled OR for severe illness of 1.47 and for death of 1.58.
The increased risk for death for men versus women was also observed in a multivariate analysis that gave an OR of 1.72, say Kasi and colleagues.
The results remained consistent regardless of the country the data originated from, with men remaining at elevated risk for severe illness or death in a pooled analysis of Chinese studies (univariate ORs=1.77 and 2.27, respectively) and those from Europe and North America (univariate ORs=1.22 and 1.43, respectively).
Kasi et al acknowledge the limitations of their study, such as the inclusion of preprint articles despite the lack of peer review, “due to the rapidly evolving nature of COVID-19-related science and in order to increase our study’s power in this unique setting.”
They also highlight the overlap in the evaluated clinical outcomes, in that “[t]he definition of severe illness used in the included studies consisted of both [intensive care unit] admission and death.”
But the team nonetheless concludes: “These findings establish sex as a risk factor in the cancer patient population and suggest that it should be taken into account in the evaluation of COVID-19 risk in the oncology clinic setting.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group
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