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

Corso, Mariana Cristina Moraes; Soares, Victor Jablonski; Amorim, Anna; Cipolotti, Rosana; Magalhães, Isis Maria Quezado; Lins, Mecneide Mendes; Forsait, Silvana; Silva, Luciana N; Sousa, Ana Virginia Lopes de; Alves, Nádia Gurgel; Prado, Sara Noéme; Silva, Klerize Anecely S; Carbone, Edna Kakitani; Brumatti, Melina; Santiago, Pablo; Pereira, Kaline Maria M O; Carlesse, Fabianne; Aguiar, Marina Gondim; Marques, Rebeca Ferreira; Rechenmacher, Ciliana; Daudt, Liane Esteves; Michalowski, Mariana Bohns

doi:10.1002/pbc.29223

Cited by 17 publications

(25 citation statements)

References 31 publications

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“…Corso et al. (2021) also noted that from 179 patients they surveyed, the severity of presentation at diagnosis was significantly associated with fatal outcomes (p<0.001); of 22 deaths, 10 patients had leukemia, 2 had lymphoma, and 8 had solid tumors, while 2 patients had other cancer diagnoses ( 32 ).…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2022

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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

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Section: Resultsmentioning

confidence: 99%

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

et al. 2022

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“…We screened a total of 2759 records after transferring the databases results without duplicates. We further assessed 61 full texts for eligibility which ended up with a total of 21 articles including 14 studies and additional seven studies following manual search procedures 7 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 (Figure 1 , Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Recent research papers have identified many factors that can impact the progression of the infection including age, body mass index, co‐infection, neutropenia, initial presentation and the existence of comorbidities. 34 , 51 , 52 Paediatric patients with cancer having low socio‐economic facilities are at greater risk of developing severe COVID‐19 outcomes like hospitalisation and death. This may be related to the precarious nutritional status of children in these countries.…”

Section: Discussionmentioning

confidence: 99%

“…This may be related to the precarious nutritional status of children in these countries. 34 Sociocultural behaviours of people living in these regions and lack of adequate hygiene maintenance may also contribute to infection risk in paediatric cancer patients. 35 Moreover, the inequalities in country income may also have an impact on patients' access to health care facilities, especially during the lockdown period, which possibly explain the higher mortality in MICs in our results.…”

Section: Discussionmentioning

confidence: 99%

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

El‐Qushayri

Benmelouka²,

Dahy

et al. 2022

Reviews in Medical Virology

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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.

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“…Different international studies have shown that leukemia is one of the most frequent hematology-oncology diseases associated with SARS-CoV-2 infection. 5,7,9,13,14 The reported COVID-19-related mortality rate in pediatric patients with cancer ranges from 0.6% to 4.08%. 7,9,15,16 The impact of the pandemic on the continuity of cancer treatment has been a concern for physicians caring for children and adolescents with cancer.…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on children with cancer. Mortality according to the three waves. A report from the Argentine National Pediatric Cancer Registry (ROHA-NET)

Moreno

Chaplin

Goldman

et al. 2022

Preprint

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Background and Aims: Worldwide, the incidence of COVID-19 is lower in children than in adults and symptoms are less severe. So far, few studies from Latin America have been published on the behavior of COVID-19 in children with cancer. Purpose: To characterize the epidemiology, clinical course, morbidity, and mortality in children with cancer and COVID-19. Methods: All patients registered in the Argentine National Pediatric Cancer Registry (ROHA) with diagnosis of SARS-CoV-2 between December 4, 2020, and May 3, 2022 were included. Variables analyzed were: sex, age at COVID-19 diagnosis, clinical presentation at diagnosis, symptom severity, tumor type, intensive care requirement, specific treatment for COVID-19, vital status, and cause of death. Mortality was analyzed comparing the three main waves. Results: Overall, 888 children with cancer and COVID-19 infection were registered (484 females); 437 (49.2%) had leukemia, followed by central nervous system tumors (CNS-T) 120 (13.5%). Of the children, 57.2% (n=508) were symptomatic; 75% were febrile, and 37% (n=210) had neutropenia; 17.1% (n=152) were diagnosed within one month of cancer diagnosis. A total of 154 children had severe or critical symptoms (17%). In this study, 112 deaths were reported, 105 (94%) due to disease progression, sepsis, comorbidities, or treatment complications. Seven patients (0.8%) died from COVID-19, all diagnosed with leukemia/lymphoma. No association of deaths was found between the three waves analyzed. Conclusions: Based on the ROHA data, we may conclude that in pediatric cancer patients, contrary to what was initially expected, morbidity and mortality due to COVID-19 were not increased.

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

Cited by 17 publications

References 31 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

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

Impact of the COVID-19 pandemic on children with cancer. Mortality according to the three waves. A report from the Argentine National Pediatric Cancer Registry (ROHA-NET)

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