COVID-19 in children with cancer and continuation of cancer-directed therapy during the infection- A tertiary care center experience from India

Parambil, Badira Cheriyalinkal; Moulik, Nirmalya Roy; Dhamne, Chetan; Dhariwal, Nidhi; Narula, Gaurav; Vora, Tushar; Prasad, Maya; Chichra, Akanksha; Jatia, Shalini; Chinnaswamy, Girish; Banavali, Sripad

doi:10.22541/au.164864286.63566927/v1

Cited by 2 publications

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“…Authors of a Polish study concluded that the SARS-CoV-2 infection did not increase mortality immediately in patients with cancer, but it was associated to higher chemotherapy rates discontinuation ( 45 ). Similar results were obtained by Parambil et al and the authors concluded that chemotherapy shouldn't be interrupted upon obtaining a positive test identifying SARS-CoV-2 ( 46 ). A pending question is if chemotherapy can be continued in patients with severe disease and improve recommendations of treatment for patients with cancer and COVID-19 ( 47 ).…”

Section: Discussionsupporting

confidence: 83%

Association of Cancer Diagnosis and Therapeutic Stage With Mortality in Pediatric Patients With COVID-19, Prospective Multicenter Cohort Study From Latin America

et al. 2022

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BackgroundChildren with cancer are at risk of critical disease and mortality from COVID-19 infection. In this study, we describe the clinical characteristics of pediatric patients with cancer and COVID-19 from multiple Latin American centers and risk factors associated with mortality in this population.MethodsThis study is a multicenter, prospective cohort study conducted at 12 hospitals from 6 Latin American countries (Argentina, Bolivia, Colombia, Ecuador, Honduras and Peru) from April to November 2021. Patients younger than 14 years of age that had an oncological diagnosis and COVID-19 or multisystemic inflammatory syndrome in children (MIS-C) who were treated in the inpatient setting were included. The primary exposure was the diagnosis and treatment status, and the primary outcome was mortality. We defined “new diagnosis” as patients with no previous diagnosis of cancer, “established diagnosis” as patients with cancer and ongoing treatment and “relapse” as patients with cancer and ongoing treatment that had a prior cancer-free period. A frequentist analysis was performed including a multivariate logistic regression for mortality.ResultsTwo hundred and ten patients were included in the study; 30 (14%) died during the study period and 67% of patients who died were admitted to critical care. Demographics were similar in survivors and non-survivors. Patients with low weight for age (<-2SD) had higher mortality (28 vs. 3%, p = 0.019). There was statistically significant difference of mortality between patients with new diagnosis (36.7%), established diagnosis (1.4%) and relapse (60%), (p <0.001). Most patients had hematological cancers (69%) and they had higher mortality (18%) compared to solid tumors (6%, p= 0.032). Patients with concomitant bacterial infections had higher mortality (40%, p = 0.001). MIS-C, respiratory distress, cardiovascular symptoms, altered mental status and acute kidney injury on admission were associated with higher mortality. Acidosis, hypoxemia, lymphocytosis, severe neutropenia, anemia and thrombocytopenia on admission were also associated with mortality. A multivariate logistic regression showed risk factors associated with mortality: concomitant bacterial infection OR 3 95%CI (1.1–8.5), respiratory symptoms OR 5.7 95%CI (1.7–19.4), cardiovascular OR 5.2 95%CI (1.2–14.2), new cancer diagnosis OR 12 95%CI (1.3–102) and relapse OR 25 95%CI (2.9–214).ConclusionOur study shows that pediatric patients with new onset diagnosis of cancer and patients with relapse have higher odds of all-cause mortality in the setting of COVID-19. This information would help develop an early identification of patients with cancer and COVID-19 with higher risk of mortality.

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Section: Discussionsupporting

confidence: 83%

Association of Cancer Diagnosis and Therapeutic Stage With Mortality in Pediatric Patients With COVID-19, Prospective Multicenter Cohort Study From Latin America

et al. 2022

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Outcome of COVID-19 in Indian patients with cancer

Seshachalam¹,

Saju²,

Raju³

et al. 2022

Cancer Research, Statistics, and Treatment

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Background: Managing patients with cancer during the coronavirus disease 2019 (COVID-19) pandemic has been challenging. Disruptions in cancer management have been observed due to cancellation of treatment, issues related to commuting, and dearth of health-care workers. Objectives: This study was conducted during the first wave of the COVID-19 pandemic and was aimed at evaluating the 30-day all-cause mortality among patients with cancer and COVID-19 infection and the factors affecting it. Materials and Methods: In this retrospective study, we collected secondary data from nine tertiary care centers in South India over a period of 10 months from March to Dec 2020. Patients across all age groups with histopathologically confirmed diagnosis of cancer who were affected by COVID-19 during their evaluation or treatment were included in the study. The primary outcome variables of the present study were 30-day all-cause mortality, cancer outcomes, and COVID-19 outcomes. Results: A total of 206 patients were included. Median age of the cohort was 55.5 years, and the male-to-female ratio was 1:1.03. The 30-day mortality rate was 12.6%. Twenty-two patients (10.7%) had severe COVID-19 infection at the initial presentation. Predictors for severe pneumonia at the initial presentation were incomplete remission at the time of COVID-19 diagnosis and palliative intent of treatment. Severe pneumonia at the initial presentation, diagnosis of COVID-19 on or before August 2020, and need for ventilator support were associated with increased mortality. Conclusion: Severity of infection at the initial presentation, cancer status, and the intent of cancer treatment impact COVID-19 outcomes in patients with cancer.

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COVID-19 in children with cancer and continuation of cancer-directed therapy during the infection- A tertiary care center experience from India

Cited by 2 publications

References 0 publications

Association of Cancer Diagnosis and Therapeutic Stage With Mortality in Pediatric Patients With COVID-19, Prospective Multicenter Cohort Study From Latin America

Association of Cancer Diagnosis and Therapeutic Stage With Mortality in Pediatric Patients With COVID-19, Prospective Multicenter Cohort Study From Latin America

Outcome of COVID-19 in Indian patients with cancer

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