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SYSTEMATIC REVIEW article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1259112

Association of Immune Checkpoint Inhibitors with SARS-CoV-2 Infection Rate and Prognosis in Patients with Solid Tumors: A Systematic Review and Meta-Analysis

Provisionally accepted
Lin Sun Lin Sun 1Fangmin Zhao Fangmin Zhao 1Yuying Xiang Yuying Xiang 1Shuyi Chen Shuyi Chen 2Qijin Shu Qijin Shu 2*
  • 1 Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
  • 2 Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China

The final, formatted version of the article will be published soon.

    The rate and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with solid cancer tumors actively treated with immune checkpoint inhibitors (ICIs) have not been fully determined. The goal of this meta-analysis was to explore this issue, which can be helpful to clinicians in their decision-making concerning patient treatment. We conducted a thorough search for relevant cohort studies in the databases PubMed, Embase, Cochrane Library, and Web of Science. Mortality and infection rate were the primary endpoints, and the incidence of severe or critical disease was the secondary result. A total of 6,267 cases (individual patients) were represented in 15 studies. Prior exposure to ICIs was not correlated with an elevated risk of SARS-CoV-2 infection (relative risk (RR) 1.04, 95% CI 0.57–1.88, z = 0.12, P = 0.905) or mortality (RR 1.22, 95% CI 0.99–1.50, z = 1.90, P = 0.057). However, the results of the meta-analysis revealed that taking ICIs before SARS-CoV-2 diagnosis increased the chance of developing severe or critical disease (RR 1.51, 95% CI 1.09–2.10, z = 2.46, P = 0.014). No significant inter-study heterogeneity was observed. The infection and mortality rates of SARS-CoV-2 in patients with solid tumors who previously received ICIs or other antitumor therapies did not differ significantly. However, secondary outcomes showed that ICIs treatment before the diagnosis of SARS-CoV-2 infection was significantly associated with the probability of severe or critical illness.

    Keywords: SARS-CoV-2, immune checkpoint inhibitors, Cancer, Infection, Mortality, metaanalysis

    Received: 15 Jul 2023; Accepted: 15 May 2024.

    Copyright: © 2024 Sun, Zhao, Xiang, Chen and Shu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Qijin Shu, Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310003, Zhejiang Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.