Mortality in patients with cancer and coronavirus disease 2019: A systematic review and pooled analysis of 52 studies

Eur J Cancer. 2020 Nov:139:43-50. doi: 10.1016/j.ejca.2020.08.011. Epub 2020 Sep 2.


Background: Patients with coronavirus disease 2019 (COVID-19) who have underlying malignancy have a higher mortality rate compared with those without cancer, although the magnitude of such excess risk is not clearly defined. We performed a systematic review and pooled analysis to provide precise estimates of the mortality rate among patients with both cancer and COVID-19.

Methods: A systematic literature search involving peer-reviewed publications, preprints and conference proceedings up to July 16, 2020, was performed. The primary end-point was the case fatality rate (CFR), defined as the rate of death among patients with cancer and COVID-19. The CFR was assessed with a random effects model, which was used to derive a pooled CFR and its 95% confidence interval (CI).

Results: Fifty-two studies, involving a total of 18,650 patients with both COVID-19 and cancer, were selected for the pooled analysis. A total of 4243 deaths were recorded in this population. The probability of death was 25.6% (95% CI: 22.0%-29.5%; I2 = 48.9%) in this patient population.

Conclusions: Patients with cancer who develop COVID-19 have high probability of mortality. Appropriate and aggressive preventive measures must be taken to reduce the risk of COVID-19 in patients with cancer and to optimally manage those who do contract the infection.

Keywords: CFR; COVID-19; Cancer; Death rate; Malignancy; Mortality; Pandemic; SARS-CoV-2.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / virology
  • Humans
  • Neoplasms / epidemiology
  • Neoplasms / mortality*
  • Neoplasms / virology*
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / virology
  • Prognosis
  • SARS-CoV-2
  • Survival Rate