Evaluating Accuracy of Medical Information Distribution Regarding Risk of COVID-19 Infections and Childhood Cancer Survivors

Abstract

In a recent study, Gupta et al 1 investigated the risk and severity of COVID-19 disease in young cancer survivors and concluded that young cancer survivors do not face higher risks or more severe complications of COVID-19 disease. We would like to congratulate the authors for this highly comprehensive study. Nonetheless, we would like to highlight certain issues and suggestions toward this study.The results from the study by Gupta et al 1 have shown that young cancer survivors do not face a higher risk of COVID-19 disease as compared with the control group, which were established on the basis of demographic and medical characteristics such as age, income, and presence of various medical diagnosis. However, likewise mentioned in this study, a study by Cheung et al 2 concluded higher anxiety levels over COVID-19 disease among childhood cancer survivors and caretakers. It is safe to assume that childhood survivors of cancer and caretakers take extra efforts against COVID-19 disease, such as diligently wearing masks, which is proven by Brooks and Butler 3 to lower the risk of COVID-19 disease for childhood cancer survivors. As such, we believe there is a need to address the possibility that childhood cancer survivors are not experiencing higher infection rates than the control group because of more precautionary actions taken against COVID-19 infections compared with the control group to make for a more accurate study on this topic.

Reply to W.L. Lee et al

“…Adjustment for these comorbidities in our analyses would result, if anything, in a decrease of our estimate of the magnitude of risk faced by survivors. We respectfully disagree with the suggestion by Lee et al 1 to exclude survivors and controls with risk factors (such as hypertension and diabetes) as this may hide one of the key mechanisms underlying increased COVID-19 risks among the former.…”

“…We do, however, entirely endorse the conclusion by Lee et al 1 . The pandemic has exposed key weaknesses in the medical community's ability to inform patients, survivors, and caregivers on how to balance competing risks in the context of significant uncertainty and constantly and rapidly evolving knowledge.…”

“…In their letter, Lee et al 1 make two main points about our findings. First, they note that although we found no increased risk among survivors of receiving a positive COVID-19 test, behavioral patterns such as mask-wearing and avoidance of close contacts were unlikely to have been identical between survivors and controls.…”

“…Second, Lee et al 1 note that comorbidities such as diabetes and hypertension are more common among childhood cancer survivors, a finding that has been replicated in multiple cohorts, 3,4 and worry that this difference may have affected our conclusions. We consider the ability of our study to identify multiple comorbidities associated with poor COVID-19 outcomes to be a key strength of the analysis.…”

“…We would like to thank Lee et al 1 for their interest in and comments on our recently published study. In that study, we examined the risks of COVID-19 disease and subsequent severe sequelae in a population-based cohort of childhood cancer survivors and found no increased risk in survivors compared with matched population controls.…”