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Pediatric Oncology Patients and COVID-19: An Experience from the Tertiary COVID Care Facility in Eastern India: A Prospective Observational StudyFunding The research was not funded by any organizations.
Introduction Pediatric oncology patients presumably are one of the most vulnerable groups during this ongoing coronavirus disease 2019 (COVID-19) pandemic. Not only they are immunocompromised thanks to their inherent disease and treatment regimens, but delay in initiation and maintenance of their treatment in this pandemic era also poses great concern. But the magnitude of this effect on pediatric oncology patients has not been well established due to paucity of data.
Objective This study was proposed to assess clinicoepidemiological profile and outcome of the pediatric oncology patients who were infected with severe acute respiratory syndrome coronavirus 2 virus attending a COVID-19 care facility.
Materials and Methods This was a prospective observational study conducted in a tertiary care hospital. All confirmed oncology patients up to age 12 years who either attended the oncology outpatient department or referred to COVID-19 care center from other cancer treatment facility were included in the study from May 2020 to September 2020. Data on demography, clinical features, investigations, treatment, complications, and outcome were collected. Descriptive statistical analysis was performed and common relevant investigations were compared between non-intensive care unit (ICU) and ICU group.
Results The rate of COVID-19 positivity among the pediatric oncology patient attending oncology clinic of the hospital is 8.21%. Total 28 patients (12 from oncology clinic of our hospital and 16 from other hospitals referred to our COVID-19 unit) were included in our study. The most common malignancy was acute lymphoblastic leukemia (64.28%). The most common symptom was fever (64.28%). Oxygen therapy was needed for 42.85% patients. Eight patients required ICU admission (two required invasive ventilation and one required noninvasive ventilation). Positive C-reactive protein value was associated with severe disease requiring ICU admission. Mean delay in starting chemotherapy in newly diagnosed cases was 28.77 days (standard deviation = 9.67). One newly diagnosed patient expired due to preexisting disease.
Conclusion Though vulnerable, most of the pediatric oncology patients suffered a mild COVID-19 infection without any significant COVID-19-related morbidity and mortality. There is a significant delay in starting specific oncology therapy, that is, chemotherapy as a result of the ongoing COVID-19 pandemic in newly diagnosed pediatric oncology patients, which can increase morbidities and mortality related to malignancy.
06 August 2021 (online)
© 2021. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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- 1 Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis 2020; 20 (05) 533-534 DOI: 10.1016/S1473-3099(20)30120-1. Erratum in: Lancet Infect Dis. 2020 Sep;20(9):e215
- 2 Shekerdemian LS, Mahmood NR, Wolfe KK. et al. International COVID-19 PICU Collaborative. Characteristics and outcomes of children with coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units. JAMA Pediatr 2020; 174 (09) 868-873
- 3 Guan WJ, Liang WH, Zhao Y. et al. China Medical Treatment Expert Group for COVID-19. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J 2020; 55 (05) 2000547 DOI: 10.1183/13993003.00547-2020.
- 4 Gao Y, Chen Y, Liu M, Shi S, Tian J. Impacts of immunosuppression and immunodeficiency on COVID-19: a systematic review and meta-analysis. J Infect 2020; 81 (02) e93-e95
- 5 Cesaro S, Compagno F, Zama D. et al. Screening for SARS-CoV-2 infection in pediatric oncology patients during the epidemic peak in Italy. Pediatr Blood Cancer 2020; 67 (08) e28466 DOI: 10.1002/pbc.28466.
- 6 Liang W, Guan W, Chen R. et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol 2020; 21 (03) 335-337
- 7 Boulad F, Kamboj M, Bouvier N, Mauguen A, Kung AL. COVID-19 in children with cancer in New York City. JAMA Oncol 2020; 6 (09) 1459-1460
- 8 MOHFW govt of India. Clinical Management Protocol:Covid19.India:2020 June13.Availablefrom: https://www.mohfw.gov.in/pdf/ClinicalManagementProtocolforCOVID19.pdf. Accessed June 30, 2021
- 9 Dong Y, Mo X, Hu Y. et al. Epidemiology of COVID-19 among children in China. Pediatrics 2020; 145 (06) e2020-0702 DOI: 10.1542/peds.2020-0702.
- 10 Jain V, Yuan JM. Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis. Int J Public Health 2020; 65 (05) 533-546
- 11 Zhang L, Zhu F, Xie L. et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol 2020; 31 (07) 894-901
- 12 Ogimi C, Englund JA, Bradford MC, Qin X, Boeckh M, Waghmare A. Characteristics and outcomes of coronavirus infection in children: the role of viral factors and an immunocompromised state. J Pediatric Infect Dis Soc 2019; 8 (01) 21-28
- 13 Balduzzi A, Brivio E, Rovelli A. et al. Lessons after the early management of the COVID-19 outbreak in a pediatric transplant and hemato-oncology center embedded within a COVID-19 dedicated hospital in Lombardia, Italy. Estote parati. Bone Marrow Transplant 2020; 55 (10) 1900-1905
- 14 André N, Rouger-Gaudichon J, Brethon B. et al. COVID-19 in pediatric oncology from French pediatric oncology and hematology centers: high risk of severe forms?. Pediatr Blood Cancer 2020; 67 (07) e28392 DOI: 10.1002/pbc.28392.
- 15 Rossoff J, Patel AB, Muscat E, Kociolek LK, Muller WJ. Benign course of SARS-CoV-2 infection in a series of pediatric oncology patients. Pediatr Blood Cancer 2020; 67 (09) e28504 DOI: 10.1002/pbc.28504.
- 16 de Rojas T, Pérez-Martínez A, Cela E. et al. COVID-19 infection in children and adolescents with cancer in Madrid. Pediatr Blood Cancer 2020; 67 (07) e28397 DOI: 10.1002/pbc.28397.
- 17 Hrusak O, Kalina T, Wolf J. et al. Flash survey on severe acute respiratory syndrome coronavirus-2 infections in paediatric patients on anticancer treatment. Eur J Cancer 2020; 132: 11-16
- 18 Rouger-Gaudichon J, Gariazzo L, Thébault E. et al. Impact of COVID-19 on cancer care: a survey from the French Society of Pediatric Oncology (SFCE. Pediatr Blood Cancer 2021; 68 (01) e28554 DOI: 10.1002/pbc.28554.
- 19 Lazzerini M, Barbi E, Apicella A, Marchetti F, Cardinale F, Trobia G. Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet Child Adolesc Health 2020; 4 (05) e10-e11