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J Hematol Oncol . COVID-19 in pediatric cancer patients is associated with treatment interruptions but not with short-term mortality: a Polish national study

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  • J Hematol Oncol . COVID-19 in pediatric cancer patients is associated with treatment interruptions but not with short-term mortality: a Polish national study


    J Hematol Oncol


    . 2021 Oct 11;14(1):163.
    doi: 10.1186/s13045-021-01181-4.
    COVID-19 in pediatric cancer patients is associated with treatment interruptions but not with short-term mortality: a Polish national study


    Jadwiga Węcławek-Tompol 1 , Zuzanna Zakrzewska 2 , Olga Gryniewicz-Kwiatkowska 3 , Filip Pierlejewski 4 , Ewa Bień 5 , Agnieszka Zaucha-Prażmo 6 , Olga Zając-Spychała 7 , Anna Szmydki-Baran 8 , Agnieszka Mizia-Malarz 9 , Wioletta Bal 10 11 , Małgorzata Sawicka-Żukowska 12 , Agnieszka Kruk 13 , Anna Raciborska 14 , Agnieszka Książek 15 , Tomasz Szczepański 15 , Jarosław Peregud-Pogorzelski 13 , Maryna Krawczuk-Rybak 12 , Radosław Chaber 10 11 , Michał Matysiak 8 , Jacek Wachowiak 7 , Wojciech Młynarski 4 , Bożenna Dembowska-Bagińska 3 , Walentyna Balwierz 2 , Agnieszka Matkowska-Kocjan 16 , Bernarda Kazanowska 1 , Jan Styczyński 17 , Marek Ussowicz 18



    Affiliations

    Abstract

    Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) currently constitutes the leading and overwhelming health issue worldwide. In comparison with adults, children present milder symptoms, with most having an asymptomatic course. We hypothesized that COVID-19 infection has a negative impact on the continuation of chemotherapy and increases nonrelapse mortality.
    Material and methods: This study was performed to assess the course of SARS-CoV-2 among children with hematological or oncological malignancies and its impact on cancer therapy. Records of SARS-CoV-2 infection in 155 children with malignancies from 14 Polish centers for pediatric hematology and oncology were collected and analyzed.
    Results: SARS-CoV-2 replication was observed in 155 patients. Forty-nine patients were symptomatic, with the following being the most common manifestations: fever (31 patients), gastrointestinal symptoms (10), coryza (13), cough (13) and headache (8). In children who were retested, the median time of a positive PCR result was 16 days (range 1-70 days), but 12.7% of patients were positive beyond day + 20. The length of viral PCR positivity correlated with the absolute neutrophil count at diagnosis. Seventy-six patients did not undergo further SARS-CoV-2 testing and were considered convalescents after completion of isolation. Antibiotic therapy was administered in 15 children, remdesivir in 6, convalescent plasma in 4, oxygen therapy in 3 (1-mechanical ventilation), steroids in 2, intravenous immunoglobulins in 2, and heparin in 4. Eighty patients were treated with chemotherapy within 30 days after SARS-CoV-2 infection diagnosis or were diagnosed with SARS-CoV-2 infection during 30 days of chemotherapy administration. Respiratory symptoms associated with COVID-19 and associated with oxygen therapy were present in 4 patients in the study population, and four deaths were recorded (2 due to COVID-19 and 2 due to progressive malignancy). The probability of 100-day overall survival was 97.3% (95% CI 92.9-99%). Delay in the next chemotherapy cycle occurred in 91 of 156 cases, with a median of 14 days (range 2-105 days).
    Conclusions: For the majority of pediatric cancer patients, SARS-CoV-2 infection does not result in a severe, life-threatening course. Our data show that interruptions in therapy are common and can result in suboptimal therapy.

    Keywords: COVID-19; Chemotherapy; Pediatric; SARS-CoV-2.

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