COVID‐19 outcomes in paediatric cancer: A large scale pooled meta‐analysis of 984 cancer patients

Abstract

We aimed to study the outcomes of COVID‐19 in paediatric cancer patients. On 26 October 2021, we did a systematic search for relevant articles in seven electronic databases followed by manual search. We included cancer patients aged ≤18 years. Event rates and the 95% confidence interval (95%CI) were used to report the results. We included 21 papers after screening of 2759 records. The pooled rates of hospitalisation, intensive care unit (ICU) admission and mortality were 44% (95%CI: 30–59), 14% (95%CI: 9–21) and 9% (95%CI: 6–12), respectively. Moreover, subgroup analysis revealed that high income countries had better COVID‐19 outcomes compared to upper middle income countries and lower middle income countries in terms of hospitalisation 30% (95%CI: 17–46), 60% (95%CI: 29–84) and 47% (95%CI: 36–58), ICU admission 7% (95%CI: 1–32), 13% (95%CI: 7–23) and 18% (95%CI: 6–41), and mortality 3% (95%CI: 2–5), 12% (95%CI: 8–18) and 13% (95%CI: 8–20), in order. In general, absence of specific pharmacologic intervention to prevent infection with the scarcity of vaccination coverage data among paediatric groups and its impact, high priority caution is required to avoid SARS‐CoV‐2 infection among paediatric cancer patients. Furthermore, our results highlight the importance of promoting care facilities for this vulnerable population in low and middle income regions to ensure quality care among cancer patients during pandemic crisis.

Cancer is not a risk factor for severe COVID-19 in children, except in patients with recent allogeneic hematopoietic stem cell transplantion recipients or comorbidities.

“…A recent meta-analysis has shown that the severity and mortality of COVID-19 in this population is higher in low-middle income countries, suggesting that the inclusion of countries with different health resources may influence the analysis of the severity of COVID-19 (2,9).…”

Cancer is not a risk factor for severe COVID‐19 in children, except in patients with recent allogeneic hematopoietic stem cell transplantation or comorbidities

“…[5][6][7][8] A recent meta-analysis has shown that the severity and mortality of COVID-19 in this population is higher in low middle-income countries, suggesting that the inclusion of countries with different health resources may influence the analysis of the severity of COVID-19. 2,9 The comparison of the morbidity and mortality of COVID-19…”

Epidemiology of acute respiratory viral infections of children with cancer before the COVID-19 pandemic

“…The current outbreak of COVID-19 caused an unheard-of global threat to the practical and safe care for children with cancer. Moreover, the late diagnosis of many childhood cancers were due to limited access to healthcare due to the pandemic and fear of infection which prevented parents from seeking early medical evaluation of symptoms in their child (1)(2)(3).…”