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Systematic Review
Immune checkpoint inhibitors use and effects on prognosis of COVID-19 infection: A systematic review and meta-analysis
Yun Tian
Tongji University
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Declarations:
Declarations
- This study involved human subjects.
- The author confirmed that all appropriate ethical guidelines for the use of human subjects have been followed, any necessary IRB and/or ethics committee review has been obtained, and information about the IRB/ethics committee is included in the manuscript.
- The author has confirmed that all necessary patient/participant consent or assent has been obtained and the appropriate institutional forms have been archived. If the IRB/ethics committee waived the requirement for patient/participant consent or assent, an explanation for the waiver is included in the text.
- The author has confirmed that a statement listing potential conflicts of interest or lack thereof is included in the text.
Background: The influence of prior exposure to immune checkpoint inhibitors (ICIs) on the coronavirus disease 2019 (COVID-19) infection remains unknown.
Methods: We searched the PubMed, Embase, and Web of Science databases from the inception of each database through August 8, 2020. We included studies that reported ICI use in cancer patients and their prognosis in the context of COVID-19. Raw data from the included studies were pooled to determine effect estimates. Chi-squared and I2 tests were used to calculate heterogeneity among the included studies.
Results: Eighteen studies were included for the systematic review, and 8 of those were included in the meta-analysis. Patients with prior ICI treatment exhibited a higher rate of hospitalization (OR [odds ratio] 2.6, 95% CI 1.45-4.68, p=0.001; I2=0%) and severe disease (OR 1.98, 95% CI 1.14-3.43, p=0.015). However, the OR of mortality in ICI-exposed cases was similar to non-ICI exposed patients (OR 0.90, 95% CI 0.60-1.34, p= 0.60; I2=49%). No statistically significant difference in mortality was observed between patients exposed to ICI and other antitumor treatments.
Conclusions: Although a higher rate of hospitalization and severe disease was observed, prior exposure to ICI did not significantly increase the rate of death in the context of COVID-19.
Keywords
Immune checkpoint inhibitor, COVID-19, Prognosis, Meta-analysis
Figure 1
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Figure 5
This is a list of supplementary files associated with this preprint. Click to download.
- FigureS1.tif
Funnel plot depicting publication bias for studies evaluating mortality outcomes in COVID-19 patients.
- Table1.pdf
Table 1
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This is a preprint. It has not completed peer review.
Systematic Review
Immune checkpoint inhibitors use and effects on prognosis of COVID-19 infection: A systematic review and meta-analysis
Yun Tian
Tongji University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 23 Sep, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Immunology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Declarations:
Declarations
- This study involved human subjects.
- The author confirmed that all appropriate ethical guidelines for the use of human subjects have been followed, any necessary IRB and/or ethics committee review has been obtained, and information about the IRB/ethics committee is included in the manuscript.
- The author has confirmed that all necessary patient/participant consent or assent has been obtained and the appropriate institutional forms have been archived. If the IRB/ethics committee waived the requirement for patient/participant consent or assent, an explanation for the waiver is included in the text.
- The author has confirmed that a statement listing potential conflicts of interest or lack thereof is included in the text.
Background: The influence of prior exposure to immune checkpoint inhibitors (ICIs) on the coronavirus disease 2019 (COVID-19) infection remains unknown.
Methods: We searched the PubMed, Embase, and Web of Science databases from the inception of each database through August 8, 2020. We included studies that reported ICI use in cancer patients and their prognosis in the context of COVID-19. Raw data from the included studies were pooled to determine effect estimates. Chi-squared and I2 tests were used to calculate heterogeneity among the included studies.
Results: Eighteen studies were included for the systematic review, and 8 of those were included in the meta-analysis. Patients with prior ICI treatment exhibited a higher rate of hospitalization (OR [odds ratio] 2.6, 95% CI 1.45-4.68, p=0.001; I2=0%) and severe disease (OR 1.98, 95% CI 1.14-3.43, p=0.015). However, the OR of mortality in ICI-exposed cases was similar to non-ICI exposed patients (OR 0.90, 95% CI 0.60-1.34, p= 0.60; I2=49%). No statistically significant difference in mortality was observed between patients exposed to ICI and other antitumor treatments.
Conclusions: Although a higher rate of hospitalization and severe disease was observed, prior exposure to ICI did not significantly increase the rate of death in the context of COVID-19.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5