Screening for SARS‐CoV‐2 infection in pediatric oncology patients during the epidemic peak in Italy

Cesaro, Simone; Compagno, Francesca; Zama, Daniele; Meneghello, Linda; Giurici, Nagua; Soncini, Elena; Onofrillo, Daniela; Mercolini, Federico; Mura, Rossella; Perruccio, Katia; Santis, Raffaella De; Colombini, Antonella; Barone, Angelica; Sainati, Laura; Baretta, Valentina; Petris, Maria Grazia

doi:10.1002/pbc.28466

Cited by 18 publications

(21 citation statements)

References 9 publications

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“…At the time of our data collection, all hospitals were adopting the preventive measures recommended by national health authorities (stricter hand hygiene; use of surgical or filtering facepiece-2 masks for patients, parents, and hospital workers; restricted access; physical distancing in daily activities). Eight centers were also screening for SARS-CoV-2 with NP swabs in all patients admitted to hospital for treatment or procedures requiring sedation [ 5 ]. All of these measures may have contributed to containing the diffusion of SARS-CoV-2 infection at Italy’s pediatric hematology-oncology centers.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcome of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italian Pediatric Oncology Patients: A Study From the Infectious Diseases Working Group of the Associazione Italiana di Oncologia e Ematologia Pediatrica

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Provenzi

Zama

et al. 2020

Journal of the Pediatric Infectious Diseases Society

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136

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ABSTRACT Background Little is known as yet about the outcome of SARS-CoV-2 infection in children being treated for cancer. Methods We collected information on the clinical characteristics and outcomes of a cohort of 29 children (16 females and 13 males, median age 7 years, range [0-16]) diagnosed with SARS-CoV-2 infection while on chemotherapy/immunotherapy (N=26), or after stem cell transplantation (N=3) during the peak of the epidemic in Italy. These patients suffered from leukemia (N=16), lymphoma (N=3), solid tumors (N=10), and Langerhans cell histiocytosis (N=1). Results The course of the disease was mild in all cases, with only 12 children developing symptoms (pneumonia in 3 cases), and none needing intensive care. Fifteen patients were hospitalized, including 7 asymptomatic patients. Nine patients (including 5 with no symptoms) were given hydroxychloroquine, and 3 of them were also given lopinavir/ritonavir. Conclusions SARS-CoV-2 infection seems to take a milder clinical course in children than in adults with cancer. Specific SARS-CoV-2 treatment seems unnecessary for most children. In the light of our findings, and albeit with the necessary caution, we suggest avoiding major changes to planned anticancer treatments in pediatric patients acquiring COVID-19.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcome of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italian Pediatric Oncology Patients: A Study From the Infectious Diseases Working Group of the Associazione Italiana di Oncologia e Ematologia Pediatrica

Bisogno

Provenzi

Zama

et al. 2020

Journal of the Pediatric Infectious Diseases Society

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136

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“…The higher susceptibility of cancer patients to severe COVID-19 infection might be explained in part by their systemic immunocompromised status induced by the underlying malignancy and anticancer therapy. Furthermore, most childhood malignancies have aggressive behavior and require prolonged periods of intensive therapy, which are potentially associated with long-term side-effects such as severe impairment of innate and adaptive immunity [26][27][28]. On the other hand, some other studies suggested that children with cancer are not more susceptible to severe COVID-19 infection than other children [12,[28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, most childhood malignancies have aggressive behavior and require prolonged periods of intensive therapy, which are potentially associated with long-term side-effects such as severe impairment of innate and adaptive immunity [26][27][28]. On the other hand, some other studies suggested that children with cancer are not more susceptible to severe COVID-19 infection than other children [12,[28][29][30][31]. This controversy stems at least in part from the fact that different kinds of cancers have distinct clinical features such as different growth rates, different responses to treatment, and different prognoses.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Analysis of Clinical Characteristics and Laboratory Findings of COVID-19 between Intensive Care Unit and Non-Intensive Care Unit Pediatric Patients: A Multicenter, Retrospective, Observational Study from Iranian Network for Research in Viral Diseases (INRVD)

Fahimzad

Sedighi

Pak

et al. 2021

Preprint

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Background: To date, less is known about the clinical features of COVID-19 pediatric patients admitting to ICUs. Herein, we aimed to describe the differences in demographic characteristics, laboratory findings, clinical presentations, and outcomes between COVID-19 pediatric patients admitting to ICU and non-ICU settings.Methods: This multicenter study involved 15 general and pediatrics hospitals on confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive real-time reverse transcription polymerase chain reaction (RT-PCR) between March 19 and May 31, 2020, during the initial peak of the COVID-19 pandemic in Iran.Results: Overall, 166 patients were included, of which 61 (36.7%) required ICU admission, especially in <5 years old age group. Malignancy and heart diseases were the most frequent underlying condition. There was significant decrease in platelet counts, PH, HCO3 and base excess as well as increases in creatinine, creatine phosphokinase and potassium levels between ICU-admitted and non-ICU patients. Dyspnea was the major symptom for ICU group patients. Acute respiratory distress syndrome (ARDS), shock and acute cardiac injury were the most common features among ICU-admitted patients. The mortality rate was substantially higher in the ICU than in non-ICU patients (45.9% vs. 1.9%, respectively; P<0.001).Conclusions: Underlying diseases were the major contributing factors in COVID-19 pediatric patients for the increased ICU admissions and mortality rates. There are few paraclinical parameters for differentiating pediatrics in terms of prognosis and serious outcomes of COVID-19. Healthcare providers should consider children as a high-risk group, especially those with younger age and underlying medical conditions and define strategies to control and prevent COVID-19 transmission in this population.

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“…From the 8 March, the “lockdown” for all Italy was adopted together with the use of surgical mask, hand hygiene, and social distancing, to prevent the massive spread of SARS-CoV-2; moreover, a screening program by nasopharyngeal swab (NPS) for any patient and caregiver parent accessing the Pediatric Hematology Oncology Unit was started ( 4 ). On March 12, the patient (and her mother) underwent the NPS and both resulted negative for SARS-CoV-2.…”

Section: Case Descriptionmentioning

confidence: 99%

Case Report: SARS-CoV-2 Infection in a Child With Suprasellar Tumor and Hypothalamic-Pituitary Failure

et al. 2021

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In early 2020, a novel coronavirus leading to potentially death was discovered. Since then, the 2019 coronavirus disease (COVID-19) has spread to become a worldwide pandemic. Beyond the risks strictly related to the infection, concerns have been expressed for the endocrinological impact that COVID-19 may have, especially in vulnerable individuals with pre-existing endocrinological health conditions. To date new information is emerging regarding severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) in children but the literature is still scarce concerning this infection in patients with intracranial malignant neoplasms. We report a 9-year-old child infected with SARS-CoV-2 and recent diagnosis of suprasellar non-germinomatous germ cell tumor also suffering from diabetes insipidus and hypothalamic-pituitary failure (hypothyroidism, adrenal insufficiency, hypothalamic obesity and growth hormone deficiency) and its clinical course. The patient remained asymptomatic for the duration of the infection without requiring any change in the replacement therapeutic dosages taken before the infection. We then discuss the proposed approach to treat a pediatric patient with SARS-CoV-2 infection and hypothalamic-pituitary failure and we include a review of the literature. Our report suggests that SARS-CoV-2 infection is usually mild and self-limiting in children even those immunocompromised and with multiple endocrinological deficits. Patients are advised to keep any scheduled appointments unless informed otherwise.

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Screening for SARS‐CoV‐2 infection in pediatric oncology patients during the epidemic peak in Italy

Cited by 18 publications

References 9 publications

Clinical Characteristics and Outcome of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italian Pediatric Oncology Patients: A Study From the Infectious Diseases Working Group of the Associazione Italiana di Oncologia e Ematologia Pediatrica

Clinical Characteristics and Outcome of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italian Pediatric Oncology Patients: A Study From the Infectious Diseases Working Group of the Associazione Italiana di Oncologia e Ematologia Pediatrica

A Comparative Analysis of Clinical Characteristics and Laboratory Findings of COVID-19 between Intensive Care Unit and Non-Intensive Care Unit Pediatric Patients: A Multicenter, Retrospective, Observational Study from Iranian Network for Research in Viral Diseases (INRVD)

Case Report: SARS-CoV-2 Infection in a Child With Suprasellar Tumor and Hypothalamic-Pituitary Failure

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