COVID-19 outcomes in a large pediatric hematology-oncology center in Houston, Texas

Kamdar, Kala Y.; Kim, Taylor O; Doherty, Erin; Pfeiffer, Thomas; Qasim, Shawki L; Suell, Mary Nell; Yates, Amber M.; Blaney, Susan M.

doi:10.1080/08880018.2021.1924327

Cited by 20 publications

(33 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(2021), the authors found that 2/51 patients died from COVID-19; one patient had relapsed T-ALL while another had high-risk neuroblastoma. Both patients developed hypoxia progressive to respiratory failure and shock that was unresponsive to treatment with remdesivir and dextromethorphan ( 25 ). In a cross-sectional, cross-national study in Kuwait and Saudi Arabia, Alfraij et al.…”

Section: Resultsmentioning

confidence: 99%

The Global Impact of COVID-19 on Childhood Cancer Outcomes and Care Delivery - A Systematic Review

et al. 2022

View full text Add to dashboard Cite

BackgroundChildhood cancer represents a leading cause of death and disease burden in high income countries (HICs) and low-and-middle income countries (LMICs). It is postulated that the current COVID-19 pandemic has hampered global development of pediatric oncology care programs. This systematic review aimed to comprehensively review the global impact of COVID-19 on childhood cancer clinical outcomes and care delivery.MethodsA systematic search was conducted on PubMed, Embase, Medline, and the African Medical Index from inception to November 3, 2021 following PRISMA guidelines. A manual search was performed to identify additional relevant studies. Articles were selected based on predetermined eligibility criteria.FindingsThe majority of studies reported patients with cancer and COVID-19 presenting as asymptomatic (HICs: 33.7%, LMICs: 22.0%) or with primary manifestations of fever (HICs: 36.1%, LMICs: 51.4%) and respiratory symptoms (HICs: 29.6%, LMICs: 11.7%). LMICs also reported a high frequency of patients presenting with cough (23.6%) and gastrointestinal symptoms (10.6%). The majority of patients were generally noted to have a good prognosis; however the crude mortality rate was higher in LMICs when compared to HICs (8.0% vs 1.8%). Moreover, the pandemic has resulted in delays and interruptions to cancer therapies and delays in childhood cancer diagnoses in both HICs and LMICs. However, these findings were disproportionately reported in LMICs, with significant staff shortages, supply chain disruptions, and limited access to cancer therapies for patients.ConclusionsThe COVID-19 pandemic has resulted in delays and interruptions to childhood cancer therapies and delays in childhood cancer diagnoses, and disproportionately so within LMICs. This review provides lessons learned for future system-wide disruptions to care, as well as provides key points for moving forward better with care through the remainder of this pandemic.Systematic Review RegistrationCRD42021266758, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=266758

show abstract

Section: Resultsmentioning

confidence: 99%

The Global Impact of COVID-19 on Childhood Cancer Outcomes and Care Delivery - A Systematic Review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…After the titles and abstracts of these articles were reviewed, 190 articles were excluded, and the full texts of 44 articles were reviewed for final eligibility. A total of 29 articles were included in this systematic review [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. Eleven studies on cases of COVID-19 in adult patients ( Table 1 ) and 18 studies on cases of COVID-19 in pediatric patients were included ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…In 18 studies [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ] that reported on 54 pediatric HCT recipients, the age range was 0.6–17 years. Of the studies that reported sex (total 30 patients), 19 patients (63%) were male.…”

Section: Resultsmentioning

confidence: 99%

A Portrait of SARS-CoV-2 Infection in Patients Undergoing Hematopoietic Cell Transplantation: A Systematic Review of the Literature

et al. 2022

View full text Add to dashboard Cite

The management of COVID-19 in hematopoietic cell transplant (HCT) recipients represents a special challenge given the variable states of immune dysregulation and altered vaccine efficacy in this population. A systematic search (Ovid Medline and Embase on 1 June 2021) was needed to better understand the presenting features, prognostic factors, and treatment options. Of 897 records, 29 studies were identified in our search. Most studies reporting on adults and pediatric recipients described signs and symptoms that were typical of COVID-19. Overall, the mortality rates were high, with 21% of adults and 6% of pediatric HCT recipients succumbing to COVID-19. The factors reported to be associated with increased mortality included age (HR = 1.21, 95% CI 1.03–1.43, p = 0.02), ICU admission (HR = 4.42, 95% CI 2.25–8.65, p < 0.001 and HR = 2.26, 95% CI 1.22–4.20, p = 0.01 for allogeneic and autologous HCT recipients), and low platelet count (OR = 21.37, 95% CI 1.71–267.11, p = 0.01). Performance status was associated with decreased mortality (HR = 0.83, 95% CI 0.74–0.93, p = 0.001). A broad range of treatments was described, although no controlled studies were identified. The risk of bias, using the Newcastle–Ottawa scale, was low. Patients undergoing HCT are at a high risk of severe morbidity and mortality associated with COVID-19. Controlled studies investigating potential treatments are required to determine the efficacy and safety in this population.

show abstract

“…Correspondingly, the efficacy of mAb therapy appears to be higher in adults who are slow to produce endogenous neutralizing antibodies [ 13 ]. While outcomes are not universally poor for immunocompromised children with SARS-CoV-2 infection [ 34 , 35 ], patients receiving high-intensity chemotherapy for newly diagnosed or relapsed leukemia, as well as those with profound antibody deficiency or very low lymphocyte counts (especially <100 cells/µL), appear to be at highest risk [ 36–40 ] and should be prioritized for mAb administration. Chimeric antigen receptor (CAR) T-cell therapy causes prolonged B-cell aplasia and resulting hypogammaglobulinemia following cell infusion, placing patients potentially at risk for prolonged and severe COVID-19 [ 41 ].…”

Section: Evidence Summarymentioning

confidence: 99%

“…Based on observational studies, most pediatric patients with cancer who develop SARS-CoV-2 infection seem overall to be at low risk of severe disease [ 57 , 58 ] although their risk is higher than that of the general pediatric population [ 35 , 59 ]. These less severe outcomes may be driven partly by the predominance of patients with mild to moderate immunosuppression in these studies, such as patients with leukemia in remission, or solid tumors not receiving intensive chemotherapy [ 57 ].…”

Section: Evidence Summarymentioning

confidence: 99%

Updated Guidance on Use and Prioritization of Monoclonal Antibody Therapy for Treatment of COVID-19 in Adolescents

Wolf

Abzug

Anosike

et al. 2022

Journal of the Pediatric Infectious Diseases Society

View full text Add to dashboard Cite

Background Starting in November 2020, the US Food and Drug Administration (FDA) has issued Emergency Use Authorizations (EUAs) for multiple novel virus-neutralizing monoclonal antibody therapies, including bamlanivimab monotherapy (now revoked), bamlanivimab and etesivimab, casirivimab and imdevimab (REGEN-COV), and sotrovimab, for treatment or postexposure prophylaxis of Coronavirus disease 2019 (COVID-19) in adolescents (≥12 years of age) and adults with certain high-risk conditions. Previous guidance is now updated based on new evidence and clinical experience. Methods A panel of experts in pediatric infectious diseases, pediatric infectious diseases pharmacotherapy, and pediatric critical care medicine from 18 geographically diverse US institutions was convened. Through a series of teleconferences and web-based surveys, a guidance statement was developed and refined based on a review of the best available evidence and expert opinion. Results The course of COVID-19 in children and adolescents is typically mild, though more severe disease is occasionally observed. Evidence supporting risk stratification is incomplete. Randomized controlled trials have demonstrated the benefit of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-specific monoclonal antibody therapies in adults, but data on safety and efficacy in children or adolescents are limited. Potential harms associated with infusion reactions or anaphylaxis are reportedly low in adults. Conclusions Based on evidence available as of August 31, 2021, the panel suggests a risk-based approach to administration of SARS-CoV-2 monoclonal antibody therapy. Therapy is suggested for the treatment of mild to moderate COVID-19 in adolescents (≥12 years of age) at the highest risk of progression to hospitalization or severe disease. Therapeutic decision-making about those at moderate risk of severe disease should be individualized. Use as postexposure prophylaxis could be considered for those at the highest risk who have a high-risk exposure but are not yet diagnosed with COVID-19. Clinicians and health systems should ensure safe and timely implementation of these therapeutics that does not exacerbate existing healthcare disparities.

show abstract

COVID-19 outcomes in a large pediatric hematology-oncology center in Houston, Texas

Cited by 20 publications

References 35 publications

The Global Impact of COVID-19 on Childhood Cancer Outcomes and Care Delivery - A Systematic Review

The Global Impact of COVID-19 on Childhood Cancer Outcomes and Care Delivery - A Systematic Review

A Portrait of SARS-CoV-2 Infection in Patients Undergoing Hematopoietic Cell Transplantation: A Systematic Review of the Literature

Updated Guidance on Use and Prioritization of Monoclonal Antibody Therapy for Treatment of COVID-19 in Adolescents

Contact Info

Product

Resources

About