Objective: Various cancer societies worldwide have released guidelines to care for cancer patients suffering from COVID-19. Given the findings from our meta-analysis, in the absence of prospective data, we recommend diligent preventive care measures, full supportive care for immunosuppressed patients to minimize the risk of infection, limiting patient's visits to the hospital when possible and using telecommunication technology. Future studies should focus on collecting all the baseline characteristics of cancer patients suffering from COVID-19, all cancer and chemotherapy or radiation-related variables as well as the detailed COVID-19 care protocol followed in these patients and the dynamic biochemical and inflammatory profile of these patients during the infection.

Case report: Our meta-analysis, suffers from several limitations. All the included studies are retrospective, the number of cancer patients is small, and many important data were not reported in these studies (cancer types, stages, and treatments).

Methodology: Several groups have published on outcomes of cancer patients infected with of the SARS-CoV-2 virus causing the COVID-19 infection. However, most of these reports are single-center studies with a limited number of patients. We performed a systematic review and meta-analysis to evaluate the impact of COVID-19 infection on cancer patients. We searched PubMed, Web of Science, and Scopus for studies that reported the risk of infection and complications of COVID-19 in cancer patients. The literature search retrieved 22 studies (1018 cancer patients).

Results: The analysis showed that the frequency of cancer among COVID-19 confirmed patients was 2.1% (95% CI: 1.3%, 3%) in the overall cohort. These patients had a mortality of 21.1% (95% CI: 14.7%, 27.6%), severe/critical disease rate of 45.4% (95% CI: 37.4%, 53.3%), ICU admission rate of 14.5% (95% CI: 8.5%, 20.4%), and mechanical ventilation rate of 11.7% (95% CI: 5.5%, 18%). The double-arm analysis showed that cancer patients had higher risk of mortality (OR=3.23, 95% CI: 1.71, 6.13), severe/critical disease (OR=3.91, 95% CI: 2.70, 5.67), ICU admission (OR=3.10, 95% CI: 1.85, 5.17), and mechanical ventilation (OR=4.86, 95% CI: 1.27, 18.65), compared to non-cancer patients. Further, cancer patients had significantly lower platelet levels and a significantly higher D-Dimer, C-reactive protein, and prothrombin time

Conclusion: cancer patients are at a higher risk of COVID-19 infection-related complications. Therefore, cancer patients need diligent preventive care measures and aggressive surveillance for earlier detection of COVID-19 infection.