COVID-19 reinfection in two children with cancer

Yadav, Satya Prakash; Wadhwa, Teena; Thakkar, Dhwanee; Kapoor, Rohit; Rastogi, Neha; Sarma, Satyam

doi:10.1080/08880018.2020.1855276

Cited by 11 publications

(6 citation statements)

References 8 publications

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“… 6 However, little is known about the rate, risk factors, characteristics, severity, or outcomes of SARS-CoV-2 reinfections in children with the exception of a few case reports in immunocompromised children. 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

Risk of SARS-CoV-2 reinfections in children: a prospective national surveillance study between January, 2020, and July, 2021, in England

Mensah¹,

Campbell²,

Stowe³

et al. 2022

The Lancet Child & Adolescent Health

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Section: Introductionmentioning

confidence: 99%

Risk of SARS-CoV-2 reinfections in children: a prospective national surveillance study between January, 2020, and July, 2021, in England

Mensah¹,

Campbell²,

Stowe³

et al. 2022

The Lancet Child & Adolescent Health

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“…6 However, little is known about the rate, risk factors, characteristics, severity or outcomes of SARS-CoV-2 reinfections in children with the exception of a few cases reports in immunocompromised children. 7,8 In England, the first cases of SARS-CoV-2 emerged in late January 2020 and increased rapidly, leading to national lockdown including school closures in March 2020. 9 Cases peaked in mid-April and then declined gradually, leading to gradual easing of lockdown measures, including partial reopening of some school class years during June/July 2020, and full reopening of all school years albeit with strict infection controls in September 2020.…”

Section: Introductionmentioning

confidence: 99%

Risk of SARS-CoV-2 reinfections in children: prospective national surveillance, January 2020 to July 2021, England

Mensah¹,

Campbell²,

Stowe³

et al. 2021

Preprint

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BackgroundReinfection after primary SARS-CoV-2 infection is uncommon in adults, but little is known about the risks, characteristics, severity or outcomes of reinfection in children.MethodsWe used national SARS-CoV-2 testing data in England to estimate the risk of reinfection ≥90 days after primary infection from 01 January 2020 to 31 July 2021, which encompassed both the Alpha and Delta waves in England. Disease severity was assessed by linking reinfection cases to national hospitalisation, intensive care admission and death registrations datasets.FindingsReinfection rates closely followed community infection rates, with a small peak during the Alpha wave and a larger peak during the Delta wave. In children aged ≤16 years, there were 688,418 primary infections and 2,343 reinfections. The overall reinfection rate was 66·88/100,000 population, being higher in adults (72.53/100,000) than in children (21·53/100,000). Reinfection rates after primary infection were 0·68% overall, 0·73% in adults and 0·34% in children. Of the 109 reinfections in children admitted to hospital, 78 (72%) had underlying comorbidities. Hospitalisation rates were similar for the first (64/2343, 2·73%) and second episode (57/2343, 2·43%). Intensive care admission was rare after primary infection (n=7) or reinfection (n=4), mainly in children with comorbidities. 44 deaths occurred after primary infection within 28 days of diagnosis (44/688,418, 0·01%), none after possible reinfections.InterpretationThe risk of SARS-CoV-2 reinfection is strongly related to exposure due to community infection rates, especially during the Delta variant wave. Children had a lower risk of reinfection than adults, but reinfections were not associated with more severe disease or fatal outcomes.FundingPHE/UKHSAResearch in ContextEvidence Before this studyWe searched PubMed with the terms “COVID-19” or “SARS-CoV-2” with “reinfection” to identify publications relating to SARS-CoV-2 reinfections from 01 January until 15 November 2021. There were few publications relating to SARS-CoV-2 reinfections, and these primarily related to adults. Published studies reported very low rates of reinfection during the first few months after primary infection in adults. COVID-19 vaccines provide effective immune protection against SARS-CoV-2 infection, but recent studies have reported increasing risk of breakthrough infection with time since primary vaccination due to waning immunity. Several SARS-CoV-2 variants, including the beta, gamma and delta variants have been shown to partially evade immunity after natural infection and vaccination, potentially increasing the risk of reinfections and breakthrough infections, respectively. Data on reinfections in children are lacking and restricted mainly to case reports in immunocompromised children.Added Value of This StudyWe used national SARS-CoV-2 testing data during the first 19 months of the pandemic to estimate the risk of reinfection in children compared to adults during a period that encompassed both the Alpha and the Delta variant waves in England. We found that the risk of reinfection correlated with the risk of SARS-CoV-2 exposure and therefore, closely reflected community infection rates, with most reinfections occurring during the Delta variant wave. Whilst acknowledging the limitation of using national testing data, we found that children had a lower risk of reinfection compared to adults and that the risk of reinfection in children increased with age. Reinfections were not associated with severe disease in terms of hospitalization or intensive care admission and there were no fatalities within 28 days of the reinfection episode in children.Implications of all the Available EvidenceSARS-CoV-2 reinfections are rare in children, especially younger children, and occurred mainly during the Delta wave in England. Reinfections were not associated with more severe disease or fatal outcomes in children. COVID-19 vaccination will provide further protection against primary infections and reinfections in children.

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“…In another report from India by Yadav et al, reinfection with SARS-CoV-2 was seen in two children after recovering fully and developing immunoglobulin G (IgG) antibodies against it [ 15 ]. In our center, we did not see any case of reinfection in pediatric hematology and oncology patients.…”

Section: Discussionmentioning

confidence: 99%

Second wave of COVID-19 – Not a matter of great concern for pediatric hematologist/oncologist

Bansal

Sachdev

Chakraborty

et al. 2022

Pediatric Hematology Oncology Journal

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Coronavirus disease-19 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic and is giving rise to a serious health threat globally. SARS-CoV-2 infection ranges from asymptomatic carrier state to severe illness requiring intensive care unit (ICU) management. It is postulated that with COVID-19 infection, children are less prone to develop severe symptoms as compared with adults. The data on immunocompromised children affected with COVID-19 infection is limited and not many publications are there on the effects of 2nd wave of COVID-19 infection in pediatric hematology/oncology patients till date. In our experience during second wave, 17 patients were found to be positive for SARS-CoV-2 with a male: female ratio of 2.4: 1 and median age of 8 years (range 1–18 years). Out of these 17 patients, 10 (58.8%) patients required hospital admission whereas the remaining were managed at home. Only 1 patient required ventilatory support and there was no mortality. Though the number of pediatric patients with COVID-19 infection were more during the second wave but majority had mild to moderate symptoms and were easily managed.

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COVID-19 reinfection in two children with cancer

Cited by 11 publications

References 8 publications

Risk of SARS-CoV-2 reinfections in children: a prospective national surveillance study between January, 2020, and July, 2021, in England

Risk of SARS-CoV-2 reinfections in children: a prospective national surveillance study between January, 2020, and July, 2021, in England

Risk of SARS-CoV-2 reinfections in children: prospective national surveillance, January 2020 to July 2021, England

Second wave of COVID-19 – Not a matter of great concern for pediatric hematologist/oncologist

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