COVID‐19 infection in children with cancer and stem cell transplant recipients in Turkey: A nationwide study

Kebudi, Rejin; Kurucu, Nilgün; Tuğcu, Deniz; Hacısalihoğlu, Şadan; Fışgın, Tunç; Ocak, Süheyla; Tokuç, Gülnur; Özdemir, Nihal; Bozkurt, Ceyhun; İnce, Dilek; Aras, Seda; Ayçicek, Ali; Aksoy, Başak Adaklı; Karadaş, Nihal; Öztürk, Gülyüz; Orhan, Mehmet Fatih; Ataseven, Eda; Akbayram, Sinan; Yılmaz, Ebru; Tüfekçi, Özlem; Vural, Sema; Akyay, Arzu; Ayhan, Aylin Canbolat; Kılıç, Suar Çakı; Üzel, Veysiye Hülya; Düzenli, Yeter; Kazancı, Elif Güler; Acıpayam, Can; Elli, Murat; Tanyeli, Atilla; Karakaş, Zeynep; Somer, Ayper; Kara, Ateş

doi:10.1002/pbc.28915

Cited by 27 publications

(42 citation statements)

References 17 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One died, all other patients fully recovered, and PCR tests became negative at a median of seven (2-17) days. 2 Similar to the study by Wu et al, chemotherapy courses were interrupted in 32 (60.4%) patients and delayed for a median of 15 (3-45) days. Six were newly diagnosed patients in whom prompt initiation of treatment is very important.…”

supporting

confidence: 59%

“…Six were newly diagnosed patients in whom prompt initiation of treatment is very important. 2 It would be valuable to learn what percentage of patients in the study by Wu et al were children and whether there was any difference in delay in treatment, disease severity, and mortality compared with adults. In pediatric series, cancer treatment was modified in 40%-58% of cases (delaying chemotherapy or reducing doses and postponing surgery).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Delays in Treatment Because of COVID-19 Infection in Children With Cancer and Stem-Cell Transplant Recipients in Turkey

Kebudi

Kurucu

Tuğcu

2021

JCO Oncology Practice

Self Cite

View full text Add to dashboard Cite

We read with great interest the article "Changes in cancer management due to COVID-19 illness in patients with cancer in Northern California" by Wu et al. 1 The authors have analyzed the significant differences regarding management type and treatment intent in 131 adult and pediatric patients with cancer and COVID-19 between March 1 and June 30, 2020, at two academic institutions. The mean age was 60 (range, 3-97) years. Most had solid malignancies, and 22% had hematologic malignancies. Fifty patients (38%) required hospitalization, 19 of whom (15%) required ICU care and nine (7%) died of complications of COVID-19. Of the nine deaths, four (44%) were undergoing active cancer treatment at the time of COVID-19 diagnosis. 1

show abstract

supporting

confidence: 59%

mentioning

confidence: 99%

Delays in Treatment Because of COVID-19 Infection in Children With Cancer and Stem-Cell Transplant Recipients in Turkey

Kebudi

Kurucu

Tuğcu

2021

JCO Oncology Practice

Self Cite

View full text Add to dashboard Cite

show abstract

“…12,13 Data are scarce for children with cancer; small national series using different inclusion criteria, severity classifications, and testing strategies suggest disparities between countries with severe or critical infections ranging from 6•6% to 21% of included patients and mortality between zero and 10%. [14][15][16][17][18][19] The clinical risk factors associated with COVID-19 disease severity among these patients are not well established. 20 In addition, as 90% of children and adolescents at risk of developing cancer live in low-income and middle-income countries, evaluation of differences in infection-related treatment and outcomes is necessary to address global inequities in COVID-19 management.…”

Section: Introductionmentioning

confidence: 99%

Global characteristics and outcomes of SARS-CoV-2 infection in children and adolescents with cancer (GRCCC): a cohort study

Mukkada

Bhakta

Chantada

et al. 2021

The Lancet Oncology

Self Cite

110

117

View full text Add to dashboard Cite

Background Previous studies have shown that children and adolescents with COVID-19 generally have mild disease. Children and adolescents with cancer, however, can have severe disease when infected with respiratory viruses. In this study, we aimed to understand the clinical course and outcomes of SARS-CoV-2 infection in children and adolescents with cancer. Methods We did a cohort study with data from 131 institutions in 45 countries. We created the Global Registry of COVID-19 in Childhood Cancer to capture de-identified data pertaining to laboratory-confirmed SARS-CoV-2 infections in children and adolescents (<19 years) with cancer or having received a haematopoietic stem-cell transplantation. There were no centre-specific exclusion criteria. The registry was disseminated through professional networks through email and conferences and health-care providers were invited to submit all qualifying cases. Data for demographics, oncological diagnosis, clinical course, and cancer therapy details were collected. Primary outcomes were disease severity and modification to cancer-directed therapy. The registry remains open to data collection. Findings Of 1520 submitted episodes, 1500 patients were included in the study between April 15, 2020, and Feb 1, 2021. 1319 patients had complete 30-day follow-up. 259 (19•9%) of 1301 patients had a severe or critical infection, and 50 (3•8%) of 1319 died with the cause attributed to COVID-19 infection. Modifications to cancer-directed therapy occurred in 609 (55•8%) of 1092 patients receiving active oncological treatment. Multivariable analysis revealed several factors associated with severe or critical illness, including World Bank low-income or lower-middle-income (odds ratio [OR] 5•8 [95% CI 3•8-8•8]; p<0•0001) and upper-middle-income (1•6 [1•2-2•2]; p=0•0024) country status; age 15-18 years (1•6 [1•1-2•2]; p=0•013); absolute lymphocyte count of 300 or less cells per mm³ (2•5 [1•8-3•4]; p<0•0001), absolute neutrophil count of 500 or less cells per mm³ (1•8 [1•3-2•4]; p=0•0001), and intensive treatment (1•8 [1•3-2•3]; p=0•0005). Factors associated with treatment modification included upper-middle-income country status (OR 0•5 [95% CI 0•3-0•7]; p=0•0004), primary diagnosis of other haematological malignancies (0•5 [0•3-0•8]; p=0•0088), the presence of one of more COVID-19 symptoms at the time of presentation (1•8 [1•3-2•4]; p=0•0002), and the presence of one or more comorbidities (1•6 [1•1-2•3]; p=0•020).Interpretation In this global cohort of children and adolescents with cancer and COVID-19, severe and critical illness occurred in one fifth of patients and deaths occurred in a higher proportion than is reported in the literature in the general paediatric population. Additionally, we found that variables associated with treatment modification were not the same as those associated with greater disease severity. These data could inform clinical practice guidelines and raise awareness globally that children and adolescents with cancer are at high-risk of developing severe COVID-19 illn...

show abstract

“…First, in pediatric oncology patients, the risk of death is less than adults, but appears to be higher than the general pediatric population and may be worse when compounded by certain high-risk demographics, e.g. male, obese, and older age, or in patients with hematologic malignancies 12 , 51 , 52 , 53 , 54 . In contrast to oncology patients, published cohorts of pediatric rheumatology patients, SOT, chronic kidney disease on immune suppression, and IBD reported low rates of severe complications, but the literature is less extensive in these diseases.…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on Pediatric Immunocompromised Patients

Connelly

Chong

Esbenshade

et al. 2021

Pediatric Clinics of North America

View full text Add to dashboard Cite

Synopsis: Although living with the threat of severe infection is a constant worry for many pediatric immunocompromised patients, the pandemic begotten by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) created new fears and challenges for families and health care providers. As people around the world through government directive or independent choice moved into protective isolation, immunosuppressed children who routinely require medical management were challenged with necessary public ventures to health care facilities. Medical centers adapted by developing new approaches to care for immunocompromised children such as expanding telemedicine services and conversion to at home immune therapies to reduce infectious exposure. Testing for SARS-CoV-2 of asymptomatic patients prior to medical therapies became routine in most modern health care units and development of highly sensitive assays was critical to avoid patient and staff exposure as well as initiation of new immunosuppressive treatment in positive patients. As the prevalence of coronavirus disease (COVID-19) amplified and infected immunocompromised patients became more common, questions quickly arose including how aggressively to treat the infection with most agents still in clinical trials. Additionally how should chronic immunosuppressant drugs that may interfere with the ability to clear the virus be adjusted? Finally, what if the infection leads to excessive immune responses or flares of the underlying disorder? In this review, we explore the impact of the COVID-19 pandemic on immunocompromised children during the first year, summarizing what is known and yet to be discovered, approaches to testing and treatment of SARS-CoV-2, considerations in management of underlying immune suppressive medications, outcomes published to date, and strategies for vaccinating this unique population.

show abstract

COVID‐19 infection in children with cancer and stem cell transplant recipients in Turkey: A nationwide study

Cited by 27 publications

References 17 publications

Delays in Treatment Because of COVID-19 Infection in Children With Cancer and Stem-Cell Transplant Recipients in Turkey

Delays in Treatment Because of COVID-19 Infection in Children With Cancer and Stem-Cell Transplant Recipients in Turkey

Global characteristics and outcomes of SARS-CoV-2 infection in children and adolescents with cancer (GRCCC): a cohort study

Impact of COVID-19 on Pediatric Immunocompromised Patients

Contact Info

Product

Resources

About