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

Abstract

<jats:title>ABSTRACT</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Little is known as yet about the outcome of SARS-CoV-2 infection in children being treated for cancer.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>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).</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>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.</jats:p> </jats:sec>

Children with cancer during COVID-19 pandemic. Early experience in Mexico.

“…2 This recommendation coincides with that of Liang et al adult patients, based on a greater severity of SARS-CoV-2 observed in cancer patients in China. 8 However, these recommendations were made in the first months of the pandemic and now with the different reports around the world [4][5][6][7]9 which informed a favourable evolution in most patients, the decision to postpone or stop treatment should be reconsidered. Unfortunately reports from countries like Mexico are scarce 10 and it is difficult to predict that most cases of COVID-19 in children with cancer will recover with no complications.…”

“…Reports of children with cancer from U.S.A and Italy had informed most of the affected patients had a mild disease and very few of them required critical care. [4][5][6][7] The aim of this report is to share the experience with cancer patients cared for in a tertiary care level hospital, in Mexico City.…”

Children with cancer during COVID‐19 pandemic: Early experience in Mexico

“…States and Italy had informed that most of the affected patients had a mild disease and very few of them required critical care. [3][4][5][6] The aim of this report is to share the experience with cancer patients cared for in a tertiary care level hospital in Mexico City. of SARS-CoV-2 observed in cancer patients in China.…”

“…of SARS-CoV-2 observed in cancer patients in China. 7 However, these recommendations were made in the first months of the pandemic, now with the different reports around the world, [4][5][6]8 which informed a favorable evolution in most patients, and the decision to postpone or stop treatment should be reconsidered. Unfortunately, reports from countries like Mexico are scarce 9 and it is difficult to predict that most cases of COVID-19 in children with cancer will recover with no complications.…”

Immune checkpoint inhibitors use and effects on prognosis of COVID-19 infection: A systematic review and meta-analysis

“…After screening the title and abstract, 1556 were excluded, and the full text of the remaining 63 articles was reviewed. Among these, 18 studies reported ICI use in cancer patients and prognosis of COVID-19 infection (5,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). The 18 articles consisted of 9 cohort studies, 5 case series and 4 case reports.…”