Clinical profile and outcome of COVID-19 in pediatric hematology-oncology patients.
Keywords:cancer, children, COVID-19
Pediatric hematology- oncology patients are assumed to be predisposed to severe COVID-19 disease and complications but the robust data form low- and middle-income countries is lacking. Thus, this study was designed with primary objective to find the prevalence and outcome of COVID- 19 in children with hematological or oncological diseases. The secondary objectives were to study clinical characteristics of COVID-19, analyse outcome in terms of need of respiratory support, intensive care, mechanical ventilation or mortality, any delay in therapy and use of COVID-19 directed therapy.
Retrospective review of children with hematological or oncological diseases with confirmed COVID-19 managed at Patan Academy of Health Sciences(PAHS) from January 2020 till September 2021. Patients were screened according to the hospital screening protocol. Clinical characteristics and outcome of COVID-19 along with delay in chemotherapy or local therapy was recorded.
Twelve children tested positive for SARS- CoV-2 during the study period and one had reinfection with COVID-19. Nine(75%) were oncology patients while 3(25%) were hematology patients. Fever (83.3%) was most common symptom followed by cough(58.3%). Four(33.3% ) children had mild and 4(33.3%) had severe infection. Eight oncology patients had delay in starting or continuing chemotherapy or undergoing surgery due to COVID-19. The median duration of delay was 10.5 d (range-7-21 d). The delay in therapy in patients with COVID-19 was significant in comparison to children without COVID-19.
Critical infection with SARS-CoV-2 infection seems uncommon in children with cancer thus continuation of standard chemotherapy can be considered in mild to moderate infection.