Purpose Treatment effect of patients with co-existing tuberculosis (TB) and lung cancer (LC) is still not conclusive. This systematic review and meta-analysis aim to assess treatment regimen, the efficacy and safety of anti-cancer and anti-TB treatment in non-small cell lung cancer (NSCLC) patients with concomitant active TB. Methods A Systematic and comprehensive search was performed in the following databases: PubMed, Embase, and Web of Science, in articles and abstracts published from 1929 to 2022. Eleven articles (involving 809 co-existing TB and LC cases and 10167 LC controls) met the inconclusive criteria. Review Manager version 5.4 software and Stata version 17.0 software were used for this statistical analysis. Results The result of this meta-analysis demonstrates that OS in coexisting pulmonary TB and NSCLC was decreased compared to NSCLC alone (log HR = 1.07, 95% CI = 0.97–1.18, p＜0.001). After removing AEs related to ICI treatment, other AEs of any grade were similar in patients with or without PTB treated with chemotherapy or target drug (log RR = 0.07, 95% CI=-0.04–0.18, p = 0.64, I2 = 0.00%). Timing to anti-cancer therapy: for 39.0% (102/261) of patients, at least 1–4 weeks after the start of anti-TB therapy; for 3.4% (9/261) of patients, at 2 weeks before the start of anti-TB treatment; for 14.6% (38/261) of patients, at received the anti-TB treatment at the same time. Conclusion The result of this meta-analysis demonstrates that OS in coexisting pulmonary TB and NSCLC was decreased compared to NSCLC alone; LC patients with TB receiving first-line chemotherapy or targeted therapy and anti-TB treatment at least 1–4 weeks after the start of anti-TB treatment or at the same time will not increase the incidence of AEs.

Purpose: Treatment strategies of patients with co-existing tuberculosis (TB) and lung cancer (LC) is still not conclusive, especially for advanced non-small cell lung cancer (NSCLC) patients with synchronous or not anti-TB and anti-cancer treatments. This systematic review and meta-analysis aim to assess treatment regimen and arrangement, the efficacy and safety of anti-cancer and anti-TB treatment in NSCLC patients with concomitant active TB.Methods: A Systematic and comprehensive search was performed in the following databases: PubMed, Embase, and Web of Science, in articles and abstracts published from 1929 to 2022. Six articles (involving 261 co-existing TB and LC cases and 8681 LC controls) met the inconclusive criteria. Review Manager version 5.4 (RevMan; Cochrane, Lindon, UK) software and Stata version 17.0 software were used for this statistical analysis.Results: The result of this meta-analysis demonstrates that LC patients with PTB appear to have had poor clinical response to treatment (log OR = 0.32, 95% confidence interval [CI] 0.03 - 0.61, p= 0.03, I2=8.68%). The results showed that lung cancer patients with TB infection had more adverse events (AEs) related to Immune-checkpoint inhibition (ICI), chemotherapy, or target drug treatment (log RR=0.11, 95% CI=0.001–0.02, p= 0.04, I2=38.84%). However, after removing AEs related to ICI treatment, other AEs of any grade were similar in patients with or without PTB treated with chemotherapy or target drug (log RR=0.07, 95% CI=-0.04–0.18, p=0.64, I2=0.00%). Timing to anti-cancer therapy: for 39.0% (102/261) of patients, at least 1-4 weeks after the start of anti-TB therapy; for 3.4% (9/261) of patients, at 2 weeks before the start of anti-TB treatment; for 14.6% (38/261) of patients, at received the anti-TB treatment at the same time.Conclusion: The present meta-analysis demonstrated that LC patients with TB have a poorer treatment response than those without TB; LC patients with TB receiving first-line chemotherapy or targeted therapy and anti-TB treatment at least 1-4 weeks after the start of anti-TB treatment or at the same time will not increase the incidence of AEs.

BackgroundA novel variant of SARS-CoV-2, the Delta variant of concern (VOC), on disease severity is very unclear. In this retrospective study, we compared the clinical characteristics and the outcomes of patients infected with the Delta VOC and with wild-type strains during the local outbreak in Xi'an and Wuhan, China.MethodsThe clinical information pertaining to the 2927 cases (between February 10 and March 8, 2020) infected with wild-type strains and the 993 cases (between December 22, 2021and February 17, 2022) infected with the Delta VOC were extracted. The clinical characteristics and outcomes were compared the cohort of wild-type infection with the cohort of Delta VOC.ResultsAmong patients younger than 18 years old, the proportion of patients infected with the Delta VOC was significantly higher than that of patients infected with wild-type strains (12.2% vs. 0.3%). In cases with mild and moderate illness, the proportion of patients was higher in the Delta VOC group than that in the wild-type strain (40.9% and 56.6% vs. 0.70% and 3.10%). However, in severe and critical patients, the proportion of patients was significantly less in the Delta VOC group than that in the wild-type strain (1.6% and 0.9% vs. 24.2% and 72.0%). In cases with severe or critical illness, and in the Delta VOC cohort or the wild-type cohort, the prognosis of patients with lymphocytes blood levels that gradually rising is good after treatment, while the prognosis of patients with lymphocytes blood levels that remain low is poor and even death(p<0.001). The Cox regression analysis revealed that the infection with the lineage of the wide-type strain had a higher risk than the Delta VOC in deteriorating to critical illness (hazards ratio 2.54[95%CI 1.279–5.026]; p = 0.008).ConclusionsUnder the two different anti-epidemic situations and anti-epidemic strategies, infection with the Delta VOC is characterized by younger patients, milder illness, and decreased risk of disease prognosis, compared with the SARS-CoV-2 wild-type lineage; lymphopenia is an effective predictor of deterioration in patients with Delta VOC and wild-type strains, calling for clinicians to understand of characteristics of them according to the different anti-epidemic situations and anti-epidemic strategies, and to guide clinical decision-making.

Background: A novel variant of SARS-CoV-2, the Delta variant of concern (VOC), on disease severity is very unclear. In this retrospective study, we compared the clinical characteristics and the outcomes of patients infected with the Delta VOC and with wild-type strains during the local outbreak in Xi'an and Wuhan, China.Methods: The clinical information pertaining to the 2927 cases (between February 10 and March 8, 2020) infected with wild-type strains and the 993 cases (between December 22, 2021and February 17, 2022) infected with the Delta VOC were extracted. The clinical characteristics and outcomes were compared the cohort of wild-type infection with the cohort of Delta VOC.Results: Among patients younger than 18 years old, the proportion of patients infected with the Delta VOC was significantly higher than that of patients infected with wild-type strains (12.2% vs. 0.3%). In cases with mild and moderate illness, the proportion of patients was higher in the Delta VOC group than that in the wild-type strain (40.9% and 56.6% vs. 0.70% and 3.10%). However, in severe and critical patients, the proportion of patients was significantly less in the Delta VOC group than that in the wild-type strain (1.6% and 0.9% vs. 24.2% and 72.0%). In cases with severe or critical illness, and in the Delta VOC cohort or the wild-type cohort, the prognosis of patients with lymphocytes blood levels that gradually rising is good after treatment, while the prognosis of patients with lymphocytes blood levels that remain low is poor and even death(p＜0.001). The Cox regression analysis revealed that the infection with the lineage of the wide-type strain had a higher risk than the Delta VOC in deteriorating to critical illness (hazards ratio 2.54[95%CI 1.279-5.026]; p = 0.008). Conclusions: Infection with the Delta VOC is characterized by younger patients, milder illness, and decreased risk of disease prognosis compared with the SARS-CoV-2 wild-type lineage; lymphopenia is an effective predictor of deterioration in patients with Delta VOC and wild-type strains, calling for clinicians to understand of characteristics of them, and to guide clinical decision-making.