Clinical characteristics and mortality predictors of patients with cancer hospitalized by COVID-19 in a pediatric third-level referral center

Hernández-Regino, Laura-Monserrat; Castillejos-López, Manuel; Aquino‐Gálvez, Arnoldo; Velasco-Hidalgo, Liliana; García-Guzmán, Alda; Aguilar-Ortiz, Marco R.; Cárdenas-Cardos, Rocío; Torres‐Espíndola, Luz María

doi:10.3389/fped.2022.960334

Cited by 2 publications

(4 citation statements)

References 44 publications

(47 reference statements)

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“…For example, Corso (2021) reported a mortality of 12.3%, in contrast to the 1% reported for the general pediatric population [76]. This difference may be due to various parameters, such as tumor stage IV (p = 0.029), intubation (p < 0.001), thrombocytopenia < 25,000 cells/mm 3 (p < 0.001), D-dimer > 1 µg/mL (p = 0.003), clinical malnutrition (p = 0.0023) [76,77], and disseminated intravascular coagulation (p = 0.03) [77]. Another factor influencing mortality was recent chemotherapy (OR 2.09 CI 95% 1.09-4.08; p = 0.028) [78].…”

Section: Coinfections In Pediatric Patients With Covid-19mentioning

confidence: 80%

Challenges in Treating Pediatric Cancer Patients during the COVID-19 Pandemic: Balancing Risks and Care

Chávez-Pacheco,

Castillejos-López,

Hernández-Regino

et al. 2024

Viruses

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The COVID-19 pandemic has resulted in millions of fatalities worldwide. The case of pediatric cancer patients stands out since, despite being considered a population at risk, few studies have been carried out concerning symptom detection or the description of the mechanisms capable of modifying the course of the COVID-19 disease, such as the interaction and response between the virus and the treatment given to cancer patients. By synthesizing existing studies, this paper aims to expose the treatment challenges for pediatric patients with COVID-19 in an oncology context. Additionally, this updated review includes studies that utilized the antiviral agents Remdesivir and PaxlovidTM in pediatric cancer patients. There is no specific treatment designed exclusively for pediatric cancer patients dealing with COVID-19, and it is advisable to avoid self-medication to prevent potential side effects. Managing COVID-19 in pediatric cancer patients is indeed a substantial challenge. New strategies, such as chemotherapy application rooms, have been implemented for children with cancer who were positive for COVID-19 but asymptomatic since the risk of disease progression is greater than the risk of complications from SARS-CoV-2.

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Section: Coinfections In Pediatric Patients With Covid-19mentioning

confidence: 80%

Challenges in Treating Pediatric Cancer Patients during the COVID-19 Pandemic: Balancing Risks and Care

Chávez-Pacheco,

Castillejos-López,

Hernández-Regino

et al. 2024

Viruses

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“…Leukaemia was the rst most-common blood cancer in children who experienced COVID-19 (n = 1141, 88.5%) (3, 4, 7, 8, 12-15, 17-21, 23- 1). Among them, 579 have unclassi ed lymphoblastic leukaemia (50.7% of all leukaemias) (3, 4, 8, 12, 13, 15, 19-21, 23, 24, 26, 29-32, 39, 40, 61, 67, 70-72, 74, 75, 81, 82, 84, 86, 92, 104, 108, 113, 116, 123, 127, 132, 150, 153, 155, 161, 162, 167-174, 177, 178), 202 have unspeci ed leukaemia (17.7%) (14,18,20,35,93,96,103,107,134,147,159,167,176), 185 have B-cell lymphoblastic leukaemia (16.2%) (7, 13, 27, 28, 33, 34, 36-38, 58-60, 62, 63, 66, 68, 73, 78-80, 85, 89, 90, 94, 95, 97-100, 102, 109, 112, 115, 119-122, 124, 125, 128, 129, 131, 133, 135-137, 139, 140, 142, 143, 146, 151, 154, 156, 158, 163, 175), 150 have unclassi ed myeloid leukaemia (13.1%) (13, 15, 17, 19-21, 23, 25, 31, 32, 37-40, 59, 64, 67, 69, 77, 78, 91, 92, 94, 104, 106, 108, 110, 111, 113, 114, 116, 117, 123, 128, 129, 141, 148-150, 153, 160, 171-175), 23 have T-cell lymphoblastic leukaemia (2%) (37,38,59,76,78,118,119,126,128,157,175), and 2 have biphenotypic leukaemia (a mixture of both types of lymphoblastic and myeloid leukaemias) (0.2%) (23,99). Most of those patients had acute leukaemic conditions (n = 892, 78.2%) (3, 4, 7, 8, 13-15, 17, 19-21, 23-34, 36-40, 58-64, 66-82, 84-86, 89, 90, 92-95, 97-100, 102, 104, 106, 108-129, 131-133, 135-137, 139-143, 146-151, 153-158, 160-163, 167-175, 177, 178) and only few cases had chronic leukaemia (n = 5, 0.4%) (91,92,129).…”

Section: Leukaemiamentioning

confidence: 99%

“…Paediatric leukaemic cases with concurrent COVID-19 had a documented mortality of 99 (8.7%) (7, 8, 15, 17-21, 35, 37-40, 59-61, 74, 77, 84, 92, 93, 99, 104, 108,110, 113, 116, 147, 150, 153, 161, 171-173, 175, 176, 178), while 1034 (90.6%) of the leukaemic children recovered(3, 4, 8, 12-15, 18-21, 23-40, 58-60, 62-64, 66-82, 84-86, 89-100, 102-104, 106-109, 111- 129, 131-137, 139-143, 146, 148-151, 153-163, 167-177). Mortality was COVID-19-related in a considerable number of paediatric leukaemic cases (41/99, 41.4%)(7,21,35,39,40, 61,74, 84,92,93,99,104,113,150,153, 161,171,173,175, 176), however, COVID-19 was not attributable to death in many of the reported leukaemic children (36/99, 36.4%) (8,15, 17, 19-21, 37, 39, 40, 59, 60, 77, 92, 104, 108, 110, 116, 154, 171, 173, 175) and few studies failed to report if COVID-19 was a leading or an underlying cause of death in those leukaemic children (22/, 22.2%)(18, 38,93,147,172, 178) (see Table2).LymphomaLymphoma was the second most-common blood cancer in children who experienced COVID-19 (n = 133, 10.3%)(12-22, 31, 35, 38-40, 57, 59, 67, 78, 87, 88, 92, 93, 96, 101, 105, 108, 123, 128-130, 144, 145, 150, 152, 164, 165, 169-175, 177, 178) (see Table1). Among them, 59 have non-Hodgkin's lymphoma (44.4% of all lymphomas)(12, 15, 16, 18, 20-22, 32, 38, 39, 57, 59, 67, 78, 87, 101, 105, 129, 130, 144, 150, 165, 169-171, 174, 175, 177), 38 have unspeci ed lymphoma (28.6%)(14,35,92,93, 96, 108,172,173, 178), and 36 have Hodgkin's lymphoma (27.1%)(13, 15, 17, 19-21, 38, 40, 67, 88, 123, 128, 145, 150, 152, 164, 169-171, 174, 177).…”

mentioning

confidence: 99%

“…Mortality was COVID-19-related in a considerable number of paediatric leukaemic cases (41/99, 41.4%)(7,21,35,39,40, 61,74, 84,92,93,99,104,113,150,153, 161,171,173,175, 176), however, COVID-19 was not attributable to death in many of the reported leukaemic children (36/99, 36.4%) (8,15, 17, 19-21, 37, 39, 40, 59, 60, 77, 92, 104, 108, 110, 116, 154, 171, 173, 175) and few studies failed to report if COVID-19 was a leading or an underlying cause of death in those leukaemic children (22/, 22.2%)(18, 38,93,147,172, 178) (see Table2).LymphomaLymphoma was the second most-common blood cancer in children who experienced COVID-19 (n = 133, 10.3%)(12-22, 31, 35, 38-40, 57, 59, 67, 78, 87, 88, 92, 93, 96, 101, 105, 108, 123, 128-130, 144, 145, 150, 152, 164, 165, 169-175, 177, 178) (see Table1). Among them, 59 have non-Hodgkin's lymphoma (44.4% of all lymphomas)(12, 15, 16, 18, 20-22, 32, 38, 39, 57, 59, 67, 78, 87, 101, 105, 129, 130, 144, 150, 165, 169-171, 174, 175, 177), 38 have unspeci ed lymphoma (28.6%)(14,35,92,93, 96, 108,172,173, 178), and 36 have Hodgkin's lymphoma (27.1%)(13, 15, 17, 19-21, 38, 40, 67, 88, 123, 128, 145, 150, 152, 164, 169-171, 174, 177). Reported blood cancer status for the lymphoma in children infected with SARS-CoV-2 were active (n = 46/82, 56.1%)(12-15, 17, 19, 22, 31, 35, 59, 78, 87, 88, 93, 101, 105, 130, 145, 164, 165, 169, 170), remission (n = 32/82, 39%) (16,35, 40, 57, 128, 144, 150, 170-173, 175, 177), or relapsed/refractory (n = 4/82, 4.9%) (67, 152, 169), however, blood cancer status in these lymphoma cases was not reported in a high percentage of patients (n = 48/133, 36.1%)(18,20,21, 38,39, 67,92, 96, 108,123,129,174, 178).…”

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Blood cancer in children infected with COVID-19: A comprehensive systematic review

Alhumaid,

Noaim,

Almuslim

et al. 2023

Preprint

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Background: Blood cancer is the most common type of cancer and the leading cause of death by disease past infancy among children. Children with blood cancer are vulnerable population to viral infections such as coronavirus disease 2019 (COVID-19). Objectives: To estimate the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in blood cancer children and analyse the demographic parameters, clinical characteristics and treatment outcomes in blood cancer children with COVID-19 illness. Methods: For this systematic review, we searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline for studies on the development of COVID-19 in children with blood cancer, published from December 1, 2019 to April 30, 2023, with English language restriction. Results: Of the 3077 papers that were identified, 155 articles were included in the systematic review (83 case report, 54 cohort and 18 case-series studies). Studies involving 1289 blood cancer children with confirmed COVID-19 were analysed. Leukaemias (1141 cases) were the most frequent types of blood cancer observed in children who developed COVID-19, followed by non-Hodgkin’s lymphomas (59 cases), Hodgkin’s lymphomas (36 cases), Langerhans cell histiocytosis (7 cases), myelodysplastic syndrome (7 cases) and myeloid neoplasm (1 case). Among all 1289 blood cancer paediatric cases who transmitted SARS-CoV-2, some children were documented to be admitted to the intensive care unit (ICU) (n = 175, 13.6%), intubated and placed on mechanical ventilation (n = 111, 8.6%), suffered acute respiratory distress syndrome (n = 144, 11.2%) or died (n = 111, 8.6%). Overall, COVID-19 in children with different types of blood cancer resulted in no or low severity of disease in more than 78.6% of all included cases (COVID-19 severity: asymptomatic = 239, mild = 603, or moderate = 171). Treatment for COVID-19 was not necessary in a high number of blood cancer children (n = 94, 7.3%). Fatality in blood cancer children with COVID-19 was reported in any of the included blood cancer categories for leukaemias (n = 99, 8.7%), non-Hodgkin’s lymphomas (n = 7, 11.9%), Hodgkin’s lymphomas (n = 2, 5.5%), myelodysplastic syndrome (n = 1, 14.3%) or myeloid neoplasm (n = 1, 100%). Fatality rate in blood cancer children infected with SARS-CoV-2 was the highest in patients with Hispanic ethnicity (n = 44/111, 39.6%) and COVID-19–related fatality was highest in male patients (76.5% of deceased patients). Most studies reported to alter the intensity and regimen of anticancer treatment in blood cancer children during course of SARS-CoV-2 infection, however, many studies have reported to successfully treat COVID-19 without any changes to the anticancer treatment. Conclusion: Globally, leukaemias were the most prevalent and myeloid neoplasms were the least prevalent blood cancer types in children who developed SARS-CoV-2 infection. Children with blood cancer tend to have milder COVID-19 symptoms and are less likely to be hospitalized and have better prognosis when compared to adults. Continuation of anticancer treatment in individual paediatric blood cancer patients with COVID-19 seems to be possible.

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Clinical characteristics and mortality predictors of patients with cancer hospitalized by COVID-19 in a pediatric third-level referral center

Cited by 2 publications

References 44 publications

Challenges in Treating Pediatric Cancer Patients during the COVID-19 Pandemic: Balancing Risks and Care

Challenges in Treating Pediatric Cancer Patients during the COVID-19 Pandemic: Balancing Risks and Care

Blood cancer in children infected with COVID-19: A comprehensive systematic review

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