Delayed diagnosis and treatment of children with cancer during the COVID-19 pandemic

Dvori, Michal; Elitzur, Sarah; Barg, Assaf Arie; Barzilai‐Birenboim, Shlomit; Gilad, Gil; Amar, Shirah; Toledano, Helen; Toren, Amos; Weinreb, Sigal; Gal, Gilad; Shapira, Adi; Ash, Shifra; Izraeli, Shai; Gilad, Oded

doi:10.1007/s10147-021-01971-3

Cited by 20 publications

(17 citation statements)

References 11 publications

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“…Several patients with life-threatening diseases, including adults and children with hematological cancers, stem-cell transplant recipients, pediatric solid tumors, brain tumors, and ocular cancers such as retinoblastoma, were adversely affected due to the inability to reach their respective health care providers. [ 6 7 8 9 10 11 12 13 14 15 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children

Bansal

Aishwarya

Rao

et al. 2021

Indian J Ophthalmol

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Purpose: The novel coronavirus SARS-CoV-2 (COVID-19) and the resultant nationwide lockdown and travel restrictions led to difficulty in providing timely and regular treatment to patients with childhood cancers such as retinoblastoma. This study is aimed at assessing the demography, clinical presentation, treatment strategies, and outcome of treatment defaulters due to the lockdown. Methods: Cross-sectional, observational study of retinoblastoma patients at a tertiary care ocular oncology center during the first wave of COVID-19 and the resulting nationwide lockdown. Results: Of the 476 eyes of 326 patients undergoing active management with a median age of 57 months (range: 4–214 months), 205 (63%) patients returned for follow-up after a mean delay of 45.8 ± 24.3 weeks (range: 8–80 weeks) and 121 (37%) were defaulters according to the data analyzed till June 30, 2021. Distance of residence was ≥1000 km for 148 patients (46%). In terms of need for active treatment, the number of emergent cases was 2 (<1%), 11 (3%) were urgent, and 313 (96%) were semi-urgent. International classification groups D (n = 107 eyes, 23%) and E (n = 173 eyes, 36%) were in majority, and 13 eyes (4%) and 4 eyes (1%) were at stages 3 and 4, respectively. Prior to lockdown, 86 eyes (18%) had active tumor, which remained unchanged (n = 26, 30%) or worsened (n = 49, 60%) after failure to follow-up. Vision (47%), eye (92%), and life salvage (98%) were achieved by individualized protocol-based management after the patients returned for further management. Five children succumbed to intracranial extension. Conclusion: The COVID-19-related nationwide lockdown has deprived retinoblastoma patients of optimal and timely management, leading to prolonged treatment interruptions, delays, permanent default, and death. It is of paramount importance for all the stakeholders to increase awareness, make necessary travel and logistic arrangements, and ensure continuity of care for children with retinoblastoma.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children

Bansal

Aishwarya

Rao

et al. 2021

Indian J Ophthalmol

View full text Add to dashboard Cite

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“…Throughout the pandemic, there have been many modifications to children’s cancer treatment. [ 1 , 2 , 40 ] These modifications have included some shifts to telehealth visits, delays in imaging and other care, and modifications to chemotherapy. [ 1 , 2 , 40 ] The Global Registry reported a reduction of chemotherapy in 5.4% of patients and withholding of chemotherapy in 37.5% of patients.…”

Section: What Happens To Cancer Treatment With a Covid-19 Infection?mentioning

confidence: 99%

“…[ 1 , 2 , 40 ] These modifications have included some shifts to telehealth visits, delays in imaging and other care, and modifications to chemotherapy. [ 1 , 2 , 40 ] The Global Registry reported a reduction of chemotherapy in 5.4% of patients and withholding of chemotherapy in 37.5% of patients. [ 2 ] Similarly, POCC reported chemotherapy withheld in 41% of patients with hematologic malignancies and 30% of patients with solid tumors.…”

Section: What Happens To Cancer Treatment With a Covid-19 Infection?mentioning

confidence: 99%

“…[ 41 ] Disease surveillance has also been impacted, with delays in scans and follow-up monitoring appointments for patients who are off treatment. [ 40 ]…”

Section: What Happens To Cancer Treatment With a Covid-19 Infection?mentioning

confidence: 99%

“…[ 42 ] A large pediatric referral center in the region also noted that the volume of new solid tumor diagnoses was nearly half what would have been expected during this time period. [ 42 ] Delays in diagnosis continued to be reported worldwide throughout the pandemic, in some cases with children presenting when already critically ill. [ 40 , 43 – 46 ] Reports of these delays center on both overwhelmed hospitals and patient fear of going to the hospital. In some situations, delays in diagnosis may have both short-term and long-term effects on morbidity and mortality.…”

Section: Has Covid-19 Caused Delays In Cancer Diagnosis?mentioning

confidence: 99%

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COVID-19 in Children with Cancer

et al. 2022

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Purpose of Review This study aims to describe what is currently known about how children with cancer have been affected by the COVID-19 pandemic, including morbidity and mortality, interruptions in cancer care and delays in diagnosis, and psychosocial effects. Here we summarize the literature on how this patient population has fared during the pandemic, reviewing multiple smaller reports along with two large registries. Recent Findings Although children with cancer generally have better outcomes with COVID-19 infection than adults with cancer, their risks of hospitalization, ICU admission, and death are greatly increased compared to the general pediatric population. There are socioeconomic and ethnic disparities present in these effects. Summary Children with cancer experience significant risks from the COVID-19 pandemic. It has yet to be seen how delays and interruptions of cancer treatment and direct organ toxicities caused by the virus itself may affect long-term outcomes in these patients.

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Communication transforms the impact of the COVID‐19 pandemic on children with cancer and their families

et al. 2023

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Background The COVID‐19 pandemic altered healthcare systems globally, causing delays in care delivery and increased anxiety among patients and families. This study examined how hospital stakeholders and clinicians perceived the global impact of the COVID‐19 pandemic on children with cancer and their families. Methods This secondary analysis examined data from a qualitative study consisting of 19 focus groups conducted in 8 languages throughout 16 countries. A codebook was developed with novel codes derived inductively from transcript review. In‐depth analysis focused on the impact of the COVID‐19 pandemic on children with cancer and their families. Results Eight themes describing the impact of the pandemic on patients and their families were identified and classified into three domains: contributing factors (COVID‐19 Policies, Cancer Treatment Modifications, COVID‐19 Symptoms, Beliefs), patient‐related impacts (Quality of Care, Psychosocial impacts, Treatment Reluctance), and the central transformer (Communication). Participants described the ability of communication to transform the effect of contributing factors on patient‐related impacts. The valence of impacts depended on the quality and quantity of communication among clinicians and between clinicians and patients and families. Conclusions Communication served as the central factor impacting whether the COVID‐19 pandemic positively or negatively affected children with cancer and families. These findings emphasize the key role communication plays in delivering patient‐centered care and can guide future development of communication‐centered interventions globally.

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Delayed diagnosis and treatment of children with cancer during the COVID-19 pandemic

Cited by 20 publications

References 11 publications

Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children

Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children

COVID-19 in Children with Cancer

Communication transforms the impact of the COVID‐19 pandemic on children with cancer and their families

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