Clinical Characteristics and Outcomes of a Cohort of Pediatric Oncohematologic Patients With COVID-19 Infection in the City of Bogotá, Colombia

Abstract

Background:In children, the complications of severe acute respiratory syndrome coronavirus 2 infection occur less frequently than in adults but the characteristics of this disease in oncology patients are not well characterized. Methods: This was a retrospective study in patients younger than 18 years of age with coronavirus disease 2019 (COVID-19) and cancer diagnoses between April and September 2020. Demographic variables, laboratory, and radiologic findings and complications of each case were identified. A descriptive analysis was performed. Results: A total of 33 patients were identified; the median age was 10 years. Fifteen patients (42%) were in chemotherapy at the time of the infection diagnosis, in two patients the chemotherapy protocol was permanently suspended. The most common symptom was fever in 20 patients (60%). Seven patients (21.2%) showed mild pneumonia, four patients (12.1%) severe pneumonia, and three cases (9.0%) were classified as critical. In the evaluated cohort, five patients (15.1%) died, and in two of those, death was caused by COVID-19 infection. Conclusions: Children with an oncologic disease, the search for COVID cases should be oriented to patients with fever, including febrile neutropenia, the presence of respiratory symptoms, and the search for epidemiologic contact. A higher frequency of complications and mortality attributed to COVID-19, two in pediatric oncohematologic patients was found. Institutional strategies to detect the infection early and lower institutional infection are indicated.

COVID-19 infection in pediatric patients treated for cancer

“…Several previous reports have suggested that pediatric patients with cancer, infected with COVID-19, are at an increased risk of severe disease due to their underlying malignancy and treatment effect, similar to adults with cancer [ 16 ]. Pediatric patients with cancer who test positively for COVID-19 have been reported to require intensive care admission and to have unfavorable outcomes [ 17 , 18 ]. Continued chemotherapy during COVID-19 infection has been reported to result in dismal outcomes [ 17 , 18 ].…”

“…Pediatric patients with cancer who test positively for COVID-19 have been reported to require intensive care admission and to have unfavorable outcomes [ 17 , 18 ]. Continued chemotherapy during COVID-19 infection has been reported to result in dismal outcomes [ 17 , 18 ].…”

SARS-CoV-2 in pediatric cancer: a systematic review

“…Five patients (7.0%) died during the period of observation, one with ALL (no further details) [ 33 ], one with osteosarcoma and extensive pulmonary metastases [ 34 ], 2 with COVID-19-related multiorgan failure after SCT and CAR-T-cell therapy [ 23 ], and one patient with neuroblastoma [ 35 ]. Additionally, 15 deaths of SARS-CoV-2-positive pediatric cancer patients were reported without mentioning the underlying malignancy [ 38 – 41 ] and 5 deaths related to SARS-CoV-2 associated complications additive to refractory ALL [ 36 , 37 ] were reported.…”

Association of Cancer Diagnosis and Therapeutic Stage With Mortality in Pediatric Patients With COVID-19, Prospective Multicenter Cohort Study From Latin America

“…The global characteristics and outcomes of SARS-CoV-2 infection in children and adolescents with cancer (GRCCC) reported that the all-cause mortality in that study was 6.3%, ranging from 11% in low-middle income countries to 6% in upper-middle income countries ( 21 ). The mortality attributed to COVID-19 in this population reported by multiple studies from different countries in Latin America ranged from 6 to 12.3% ( 28 – 31 ). A study by Shahid et al performed in Pakistan, included 161 cancer patients with and without COVID-19 and compared their outcomes, finding a mortality of 6.8% in COVID-19 patients vs. 2.7% non-COVID-19 patients ( 32 ).…”