Characterization of COVID‐19 disease in pediatric oncology patients: The New York‐New Jersey regional experience

Madhusoodhan, P. Pallavi; Pierro, Joanna; Musante, Jordan; Kothari, D.P.; Gampel, B.; Appel, Burton; Levy, Adam; Tal, Adit; Hogan, Laura; Sharma, Archana; Feinberg, Shari L.; Kahn, Alissa R.; Pinchinat, Ashley; Bhatla, Teena; Glasser, Chana L.; Satwani, Prakash; Raetz, Elizabeth A.; Onel, Kenan; Carroll, William L.

doi:10.1002/pbc.28843

Cited by 90 publications

(145 citation statements)

References 18 publications

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“…Specifically, the authors describe a cohort of 98 positive patients: among them, 28 required hospitalization, 25 required oxygen support, and seven required mechanical ventilation. No deaths, however, were strictly related to the infection ( 116 ). In general, the relatively small size of the cancer pediatric population does not allow assessment of whether being affected by a hemato-oncological disease is a risk factor for a severe pattern in case of exposure to SARS-CoV-2 ( 117 ).…”

Section: Resultsmentioning

confidence: 99%

COVID-19 in Immunosuppressed Children

et al. 2021

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Following the spread of the SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19) to a global pandemic, concerns have arisen for the disease impact in at-risk populations, especially in immunocompromised hosts. On the other hand, clinical studies have clarified that the COVID-19 clinical burden is mostly due to over-inflammation and immune-mediated multiorgan injury. This has led to downsizing the role of immunosuppression as a determinant of outcome, and early reports confirm the hypothesis that patients undergoing immunosuppressive treatments do not have an increased risk of severe COVID-19 with respect to the general population. Intriguingly, SARS-CoV-2 natural reservoirs, such as bats and mice, have evolved mechanisms of tolerance involving selection of genes optimizing viral clearance through interferon type I and III responses and also dampening inflammasome response and cytokine expression. Children exhibit resistance to COVID-19 severe manifestations, and age-related features in innate and adaptive response possibly explaining this difference are discussed. A competent recognition by the innate immune system and controlled pro-inflammatory signaling seem to be the pillars of an effective response and the premise for pathogen clearance in SARS-CoV-2 infection. Immunosuppression—if not associated with other elements of fragility—do not represent per se an obstacle to this competent/tolerant phenotype in children. Several reports confirm that children receiving immunosuppressive medications have similar clinical involvement and outcomes as the pediatric general population, indicating that maintenance treatments should not be interrupted in suspect or confirmed SARS-CoV-2 infection.

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Section: Resultsmentioning

confidence: 99%

COVID-19 in Immunosuppressed Children

et al. 2021

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“…9,10 Similar to other reports, we did not find any correlation with immune status at time of infection or type A blood with the development of severe disease. 4 We did not have sufficient data to evaluate additional risk factors such as inflammatory markers, iron overload, or post-COVID cardiac function.…”

Section: Discussionmentioning

confidence: 99%

“…Early reports from China, Europe, and New York/New Jersey have shown minimal to no risk for morbidity or mortality in children with cancer and have been unable to find significant risk factors for severe disease in this patient population. 1,2,3,4,5 Here, we report three patients with pediatric cancer who developed severe cardiorespiratory dysfunction (as defined by evidence of heart failure by echocardiogram and/or intubation secondary to respiratory failure) following COVID-19 infections, with one resultant death. We compared clinical and host factors between these three patients with severe cardiorespiratory symptoms to five patients in active treatment at our institution who tested positive for COVID-19 but did not develop severe cardiorespiratory symptoms.…”

Section: Introductionmentioning

confidence: 99%

Cardiorespiratory complications in pediatric oncology patients with COVID-19 infection

Schoettler

Sue²,

Slone

et al. 2021

Preprint

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The risk of the novel coronavirus disease 2019 (COVID-19) to pediatric oncology patients is unknown. Here, we report eight pediatric oncology patients receiving active cancer therapy that tested positive for COVID-19. Three developed severe cardiorespiratory symptoms (as defined by evidence of heart failure by echocardiogram and/or intubation secondary to respiratory failure), including one death as a result of COVID-19 infection. We identified prior anthracycline exposure and pre-COVID cardiac function as significantly associated with the development of severe cardiorespiratory complications. These data merit future and further investigation of risk factors for severe complications related to COVID-19 infections in pediatric oncology patients.

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“…At the onset of the pandemic, the importance of describing the experience of children with cancer and COVID was quickly recognized. In the NY/NJ/CT region, three separate clinical studies were independently created, [19][20][21] each anticipating the need for multi-institutional data due to the rarity of COVID-positive pediatric oncology patients. At Ultimately, the key to our success was identifying the unique characteristics among the individual studies, prioritizing fellow and junior attending leadership, and streamlining data collection in areas of overlap.…”

Section: Research Collaborationmentioning

confidence: 99%

COVID‐19 has changed the way we think about training future pediatric hematologists/oncologists

Moerdler

Gampel

Levine

et al. 2021

Pediatric Blood & Cancer

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COVID‐19 has upended medical practice and education, but has also catalyzed enhancements in the field. Early on, a local group of researchers united to investigate the impact of the pandemic on pediatric hematology oncology (PHO). From this group, a regional educational series was established, “virtual‐Symposium of Pediatric Hematology/Oncology of New York” (v‐SYMPHONY). The implementation of these endeavors while PHO fellowship applications are declining has highlighted our perceptions that education, mentoring, and career expectations are not keeping up with the needs of current trainees. We describe our regional experience joining together to further education and research, and reflect on the current landscape of PHO training and workforce.

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Characterization of COVID‐19 disease in pediatric oncology patients: The New York‐New Jersey regional experience

Cited by 90 publications

References 18 publications

COVID-19 in Immunosuppressed Children

COVID-19 in Immunosuppressed Children

Cardiorespiratory complications in pediatric oncology patients with COVID-19 infection

COVID‐19 has changed the way we think about training future pediatric hematologists/oncologists

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