BackgroundThe pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected all age groups, including the pediatric population, in 3–5% of all cases. We performed a meta-analysis to understand the survival and associated complications in pediatric cancer patients as well as their hospitalization, intensive care, and ventilation care (supplemental oxygen/endotracheal intubation) needs.MethodsA systematic search was performed using MEDLINE, TRIP Database, International Clinical Trials Registry Platform (WHO), The Cochrane Library, Wiley, LILACS, and Google Scholar. Additionally, a search using the snowball method was performed in Nature, New England Journal of Medicine, Science, JAMA, ELSEVIER editorial, Oxford University Press, The Lancet, and MedRxiv. Searches were conducted until July 18, 2020. A total of 191 cancer patients with coronavirus disease 2019 (COVID-19) were integrated from 15 eligible studies. In a sub-analysis, patients were stratified into two groups: hematological cancer and solid tumors. Outcome measures were overall survival, risk of hospitalized or needing intensive care, and need for ventilatory support in any modality. The random effects statistical analysis was performed with Cochran’s chi square test. The odds ratio (OR) and heterogeneity were calculated using the I2 test.ResultsThe overall survival was 99.4%. There were no statistically significant differences in the risk of hospitalization between hematological malignancies and solid tumors (95% confidence interval [CI] 0.48–18.3; OR = 2.94). The risk of being admitted to the intensive care unit was also not different between hematological malignancies and other tumors (95% CI 0.35–5.81; OR = 1.42). No differences were found for the need of ventilatory support (95% CI 0.14–3.35; OR = 0.68). Although all the studies were cross-sectional, the mortality of these patients was 0.6% at the time of analysis.ConclusionsIn the analyzed literature, survival in the studied group of patients with COVID-19 was very high. Suffering from hematological neoplasia or other solid tumors and COVID-19 was not a risk factor in children with cancer for the analyzed outcomes.

Background: Coronavirus disease (COVID)-19 has currently affected 8,015,502 million people worldwide with global mortality around 5%. Information in pediatric cancer patients is still limited, but it is emerging day by day. The objective of this scoping review was to analyze the available data associated with COVID-19 infection and mortality in pediatric cancer patients and to provide useful information to plan and design strategies in this group. Methods: A search was conducted, and eight articles were obtained for qualitative analysis; 110 patients were included, all from cross-sectional studies. At the time of publication, all the analyzed documents reported no deaths associated with COVID-19. Results: According to the information, COVID-19 infection appears to be less severe in the pediatric population in comparison with adults and does not appear to be a cause of mortality in patients with childhood cancer. Conclusions: Given the nature of preliminary reports and a short follow-up in cancer patients, it is necessary to have medium-and long-term follow-up studies to determine the effects of infection and modifications to the treatments of these patients.

In pediatric medical practice it is common to encounter situations that represent a dilemma for health professionals. A dilemma occurs when ethical problems found in professional practice cause serious internal conflicts because they imply actions that contradict their colleagues, employees, or their own personal values and are classified as personal value conflicts, conflicts with other professionals, conflicts with clients and with organizations. A literature review allowed identifying different models to debate these types of dilemmas. The present work is a review of the search of scientific articles using databases such as Ebsco Host, ProQuest, Ovid, and InMex as well as metasearch tools such as metacrawler. The models found are as follows: Model of Anne Davis, Nijmegen method, Method of Diego Gracia, Integral method, Bochum Center Ethics model, Model of Brody and Payton, Model of Curtin and Flaherty, Model of Thompson and Thompson, SAD method, Model of Javier Morata, Model of Elaine Congress, IFSW model, Model of Loewenberg and Dolgoff, Ley Social Model, DOER method, Model of Brommer, Model of Corey and Callanan, Model of Pope and Vasquez, Model of Bush, Connell and Denney, Model of Ferrell, Gresham and Fraedrich, and Model of Hunt and Vitell. The key criteria shared in the different models are a) specifying the ethical dilemma, b) description of the facts, c) value definition, moral code and facts, decision making and d) identifying alternative solutions. In order to review the literature, some models are explained with the purpose of identifying and representing critical elements that clinical ethics committees could use in a practical manner in pediatric health institutions in Mexico.

The new COVID-19 disease is caused by a novel coronavirus (SARS-CoV-2), that probably originated in Wuhan, China, and has currently infected 505,817,953 people and caused 6,213,876 deaths in the world. On the American continent, 152,265,980 cases and 2,717,108 deaths have been reported to WHO (World Health Organization). The Latin America and the Caribbean (LAC) region presents an epidemiological challenge due to its population's heterogeneity and socioeconomic inequality. A particularly vulnerable population is that of children with cancer, and their mortality from COVID-19 has been reported to be 3.6% globally. This work aimed to study the lethality of SARS-CoV-2 infection in children with cancer in the Latin American region. Our objective was to systematically review published scientific literature and search hospital databases in Latin America to explore mortality in this region. A median of mortality of 9.8% was found in the articles analyzed. In addition, we collected five databases from Latin American hospitals. We concluded that there was an underestimation in the mortality registry of this group of patients in the analyzed region. Therefore, although the causes are unknown, it is necessary to strengthen the case-reporting system to determine the reality in complex and particular areas such as Latin America.

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