Risk factors for mortality among lung cancer patients with covid-19 infection: A systematic review and meta-analysis

BACKGROUND: Lung cancer patients with coronavirus disease 2019 (COVID-19) infection experience high mortality rates. The study aims to determine the risk factors for mortality in lung cancer patients with COVID-19 infection. MATERIALS AND METHODS: Followed the PRISMA reporting guidelines, PubMed, Embase, and Web of Science were systematically searched to February 20, 2023, for studies of lung cancer patients with COVID-19 infection. The main outcome of interest was the risk factor for mortality. We also compared the mortality rate of those patients among different continents. A pooled risk ratio (RR) with 95% CI was presented as the result of this meta-analysis. RESULTS: Meta-analysis of 33 studies involving 5018 patients showed that pooled mortality rate of lung cancer in COVID-19 patients was 0.31 (95% CI: 0.25–0.36). Subgroup analysis based on the continents showed significant difference of the mortality rate was observed between Asia and the rest of world (χ(2) = 98.96, P < 0.01). Older age (SMD: 0.24, 95% CI: 0.09–0.40, P < 0.01), advanced lung cancer (RR: 1.14, 95% CI: 1.04–1.26, P < 0.01), coexisting comorbidities such as hypertension (RR: 1.17, 95% CI: 1.01–1.35, P = 0.04) and cardiovascular disease (RR: 1.40, 95% CI: 1.03–1.91, P = 0.03) were associated with higher risk of mortality rate in those patients. CONCLUSIONS: Findings of this meta-analysis confirms an increased risk of mortality in lung cancer patients with COVID-19 infection, whose risk factors for these patients appear to be exacerbated by older age, advanced-stage lung cancer, and comorbidities such as hypertension and cardiovascular disease.