Covid-19 in Pediatric Cancer Patients in a Resource-Limited Setting: National Data From Peru

Montoya, Jacqueline; Ugaz, Cecilia; Alarcon, Sandra; Maradiegue, Essy; Garcı́a, Juan Luis; Díaz, Rosdali; Zapata, Arturo; Chávez, Sharon; Morales, Roxana; Ordoñez, Katy; Hernández, Eddy; Reaño, Romulo; Vargas, María Pía; Gutierrez, Christina; Sánchez, Katherine; Valdiviezo, Cinthya; Rojas, Ninoska; Moore, Carla; León, Esmeralda; Maza, Iván; Vásquez, Liliana

doi:10.22541/au.159430753.36373086

Cited by 9 publications

(21 citation statements)

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“…79 While several reports have documented that adult oncology patients are at higher risk of complications from COVID-19 than those without cancer, 80,81 the impact of SARS-CoV-2 on children with malig- 84 In a study from Peru, almost half of 69 pediatric patients with cancer presented asymptomatic SARS-CoV-2 infection. 85 The most common clinical manifestations in symptomatic infection were fever and cough. 85,86 The authors commented that from current evidence, pediatric patients with cancer do not appear to have a higher mortality rate from SARS-CoV-2 infection, although these patients may have a worse outcome in low-and middle-income countries.…”

Section: Covid-19 Infection In Pediatric Oncology Patientsmentioning

confidence: 99%

“…85 The most common clinical manifestations in symptomatic infection were fever and cough. 85,86 The authors commented that from current evidence, pediatric patients with cancer do not appear to have a higher mortality rate from SARS-CoV-2 infection, although these patients may have a worse outcome in low-and middle-income countries. 85 In a study of 15 children from Madrid, 73% with hematological malignancies and 27% with solid tumors, the median WBC count at COVID-19 diagnosis was 3195/mm 3 (range 90-10 690), the median lymphocyte count was 580/mm 3 (range 0-6310), and the median D-dimer level was 291 ng/mL (range 0.7-2620).…”

Section: Covid-19 Infection In Pediatric Oncology Patientsmentioning

confidence: 99%

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Hematological manifestations of SARS‐CoV‐2 in children

Kosmeri

Koumpis

Tsabouri

et al. 2020

Pediatric Blood & Cancer

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Infection from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), though mainly a respiratory disease, can impair many systems, including causing hematological complications. Lymphopenia and hypercoagulability have been reported in adults with coronavirus disease 2019 (COVID-19) and are considered markers of poor prognosis. This review summarizes the hematological findings in children with SARS-CoV-2 infection. The majority of infected children had a normal leukocyte count, while the most common white blood cell abnormality was leukopenia. Lymphopenia, which may be a marker of severe disease, was rarer in children than in adults, possibly due to their immature immune system or due to the less severe manifestation of COVID-19 in this age group. Age may have an impact, and in neonates and infants the most common abnormality was lymphocytosis. Abnormalities of red blood cells and platelets were uncommon. Anemia and hypercoagulability were reported mainly in children presenting the novel multisystem inflammatory syndrome (MIS) associated with SARS-CoV-2.

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Section: Covid-19 Infection In Pediatric Oncology Patientsmentioning

confidence: 99%

Section: Covid-19 Infection In Pediatric Oncology Patientsmentioning

confidence: 99%

Hematological manifestations of SARS‐CoV‐2 in children

Kosmeri

Koumpis

Tsabouri

et al. 2020

Pediatric Blood & Cancer

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“…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

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109

117

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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...

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“…Results: One hundred seventy-nine patients were included (median age 6 [4][5][6][7][8][9][10][11][12][13] years, 58% male). Of these, 55.9% had acute leukemia and 34.1% had solid tumors.…”

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confidence: 99%

SARS‐CoV‐2 in children with cancer in Brazil: Results of a multicenter national registry

Corso

Soares

Amorim

et al. 2021

Pediatric Blood & Cancer

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Background Strategies to mitigate the impact of COVID‐19 in special populations are complex and challenging. Few studies have addressed the impact of COVID‐19 on pediatric patients with cancer in low‐ and middle‐income countries. Methods Multicenter observational cohort study with prospective records and retrospective analyses starting in April 2020 in 21 pediatric oncology centers distributed throughout Brazil. Participants: Patients under 18 years of age who are infected by the SARS‐CoV‐2 virus (confirmed diagnosis through reverse transcriptase‐polymerase chain reaction [RT‐PCR]) while under treatment at pediatric oncology centers. The variables of interest included clinical symptoms, diagnostic and therapeutic measures. The repercussions of SARS‐CoV‐2 infection on cancer treatment and general prognosis were monitored. Results One hundred seventy‐nine patients were included (median age 6 [4–13] years, 58% male). Of these, 55.9% had acute leukemia and 34.1% had solid tumors. The presence of SARS‐CoV‐2 was diagnosed by RT‐PCR. Various laboratory markers were analyzed, but showed no correlation with outcome. Children with low or high BMI for age had lower overall survival (71.4% and 82.6%, respectively) than those with age‐appropriate BMI (92.7%) ( p = .007). The severity of presentation at diagnosis was significantly associated with outcome ( p < .001). Overall mortality in the presence of infection was 12.3% ( n = 22). Conclusion In children with cancer and COVID‐19, lower BMI was associated with worse prognosis. The mortality in this group of patients (12.3%) was significantly higher than that described in the pediatric population overall (∼1%).

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Covid-19 in Pediatric Cancer Patients in a Resource-Limited Setting: National Data From Peru

Cited by 9 publications

References 0 publications

Hematological manifestations of SARS‐CoV‐2 in children

Hematological manifestations of SARS‐CoV‐2 in children

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

SARS‐CoV‐2 in children with cancer in Brazil: Results of a multicenter national registry

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