Meta-analysis of mortality factors after COVID-19 infection in pediatric oncology patients

ObjectiveThere are few clinical studies related to COVID-19 in pediatric cancer patients, and systematic reviews or meta-analyses on its mortality risk factors are particularly lacking. Therefore, we conducted this meta-analysis to systematically analyze the mortality risk factors of pediatric cance...

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Main Authors: Qingchen Liu, Xia Wang, Xueqin Zhou
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1594617/full
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author Qingchen Liu
Qingchen Liu
Xia Wang
Xia Wang
Xueqin Zhou
Xueqin Zhou
author_facet Qingchen Liu
Qingchen Liu
Xia Wang
Xia Wang
Xueqin Zhou
Xueqin Zhou
author_sort Qingchen Liu
collection DOAJ
description ObjectiveThere are few clinical studies related to COVID-19 in pediatric cancer patients, and systematic reviews or meta-analyses on its mortality risk factors are particularly lacking. Therefore, we conducted this meta-analysis to systematically analyze the mortality risk factors of pediatric cancer patients after COVID-19 infection, providing effective evidence-based medical evidence for epidemic prevention and control and clinical treatment of pediatric COVID-19 patients.MethodsElectronic databases of PubMed, Embase, Cochrane Library and Web of Science were searched using “cancer” “COVID-19” “children” “mortality” related subject headings and keywords. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Outcomes included age, weight, clinical complications in patients, cancer type, consolidation of cancer treatment, and critical illness. The quality of observational studies was assessed using the Newcastle-Ottawa Scale, which includes criteria such as study population selection, comparability, and evaluation of exposure or outcome, by two independent reviewers.ResultsA computerized search of the literature yielded six observational studies with a total of 2,696 patients, and a pooled assessment of predictive factors revealed that the occurrence of adverse clinical complications, the presence of solid tumors, and the presence of acute and critical conditions significantly increased mortality in pediatric oncology patients (P < 0.05), although, overall, aggressive consolidation of cancer treatment significantly reduced the death of patients. Although overall,being in the cancer consolidation treatment period is significantly associated with a reduced risk of patient mortality, there is still an increase in mortality with Radiotherapy, possibly due to immunocompromise (P < 0.05), whereas Immunotherapy and Surgery do not affect patient prognosis. Subgroup analyses showed that prolonged consolidation of cancer treatment reduced mortality. The sensitivity analysis of the results of the outcome indicators was stable with low sensitivity and high confidence.ConclusionAdverse clinical complications, the presence of solid tumors, and the occurrence of critical conditions increase mortality in pediatric cancer patients. Receiving aggressive cancer treatment is associated with lower mortality rates, but this association should be interpreted with caution, as it may be confounded by other factors.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420250570932.
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spelling doaj-art-e0d1194495f7437db4e942bde09512c62025-08-20T03:44:25ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.15946171594617Meta-analysis of mortality factors after COVID-19 infection in pediatric oncology patientsQingchen Liu0Qingchen Liu1Xia Wang2Xia Wang3Xueqin Zhou4Xueqin Zhou5People’s Hospital of Fengjie, Chongqing, ChinaGynaecology, People’s Hospital of Fengjie, Chongqing, ChinaPeople’s Hospital of Fengjie, Chongqing, ChinaDepartment of Gynecology and Obstetrics, People’s Hospital of Fengjie, Chongqing, ChinaPeople’s Hospital of Fengjie, Chongqing, ChinaGynaecology, People’s Hospital of Fengjie, Chongqing, ChinaObjectiveThere are few clinical studies related to COVID-19 in pediatric cancer patients, and systematic reviews or meta-analyses on its mortality risk factors are particularly lacking. Therefore, we conducted this meta-analysis to systematically analyze the mortality risk factors of pediatric cancer patients after COVID-19 infection, providing effective evidence-based medical evidence for epidemic prevention and control and clinical treatment of pediatric COVID-19 patients.MethodsElectronic databases of PubMed, Embase, Cochrane Library and Web of Science were searched using “cancer” “COVID-19” “children” “mortality” related subject headings and keywords. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Outcomes included age, weight, clinical complications in patients, cancer type, consolidation of cancer treatment, and critical illness. The quality of observational studies was assessed using the Newcastle-Ottawa Scale, which includes criteria such as study population selection, comparability, and evaluation of exposure or outcome, by two independent reviewers.ResultsA computerized search of the literature yielded six observational studies with a total of 2,696 patients, and a pooled assessment of predictive factors revealed that the occurrence of adverse clinical complications, the presence of solid tumors, and the presence of acute and critical conditions significantly increased mortality in pediatric oncology patients (P < 0.05), although, overall, aggressive consolidation of cancer treatment significantly reduced the death of patients. Although overall,being in the cancer consolidation treatment period is significantly associated with a reduced risk of patient mortality, there is still an increase in mortality with Radiotherapy, possibly due to immunocompromise (P < 0.05), whereas Immunotherapy and Surgery do not affect patient prognosis. Subgroup analyses showed that prolonged consolidation of cancer treatment reduced mortality. The sensitivity analysis of the results of the outcome indicators was stable with low sensitivity and high confidence.ConclusionAdverse clinical complications, the presence of solid tumors, and the occurrence of critical conditions increase mortality in pediatric cancer patients. Receiving aggressive cancer treatment is associated with lower mortality rates, but this association should be interpreted with caution, as it may be confounded by other factors.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420250570932.https://www.frontiersin.org/articles/10.3389/fonc.2025.1594617/fullpediatric tumorsCOVID-19mortality factorsprognosismeta-analysis
spellingShingle Qingchen Liu
Qingchen Liu
Xia Wang
Xia Wang
Xueqin Zhou
Xueqin Zhou
Meta-analysis of mortality factors after COVID-19 infection in pediatric oncology patients
Frontiers in Oncology
pediatric tumors
COVID-19
mortality factors
prognosis
meta-analysis
title Meta-analysis of mortality factors after COVID-19 infection in pediatric oncology patients
title_full Meta-analysis of mortality factors after COVID-19 infection in pediatric oncology patients
title_fullStr Meta-analysis of mortality factors after COVID-19 infection in pediatric oncology patients
title_full_unstemmed Meta-analysis of mortality factors after COVID-19 infection in pediatric oncology patients
title_short Meta-analysis of mortality factors after COVID-19 infection in pediatric oncology patients
title_sort meta analysis of mortality factors after covid 19 infection in pediatric oncology patients
topic pediatric tumors
COVID-19
mortality factors
prognosis
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1594617/full
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