Delayed cancer diagnoses and high mortality in children during the COVID‐19 pandemic

Ding, Yangyang; Ramakrishna, Sneha; Long, Adrienne H.; Phillips, Charles; Montiel-Esparza, Raúl; Diorio, Caroline; Bailey, Leonard C.; Maude, Shannon L.; Aplenc, Richard; Batra, Vandana; Reilly, Anne; Rheingold, Susan R.; Lacayo, Norman J.; Sakamoto, Kathleen M.; Hunger, Stephen P.

doi:10.1002/pbc.28427

Cited by 77 publications

(88 citation statements)

References 4 publications

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“…Peru, an upper‐middle income country according to the World Bank, is being severely affected by the COVID‐19 pandemic, counting today 285 213 cases and 9677 deaths, and having one of the highest incidence rates of COVID‐19 in the world (87.5 per million inhabitants) 1 . National lockdown policies, transportation restriction, and economic constrains, along with disrupted health care services, have significantly impacted access for diagnosis and treatment of children with cancer 2,3 . Although recent papers suggest that the pediatric oncology population may not have higher mortality resulting from SARS‐CoV‐2 infection in high‐income countries (Spain, 4 China, 5 USA, 6 Italy 7 ), these patients would be a potential vulnerable group for worse outcomes, 8 especially in low‐ and middle‐income countries (LMIC).…”

Section: Characteristic (N = 69)mentioning

confidence: 99%

COVID‐19 in pediatric cancer patients in a resource‐limited setting: National data from Peru

Montoya

Ugaz

Alarcon

et al. 2020

Pediatric Blood & Cancer

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Peru, an upper-middle income country according to the World Bank, is being severely affected by the COVID-19 pandemic, counting today 285 213 cases and 9677 deaths, and having one of the highest incidence rates of COVID-19 in the world (87.5 per million inhabitants). 1 National lockdown policies, transportation restriction, and economic constrains, along with disrupted health care services, have significantly impacted access for diagnosis and treatment of children with cancer. 2,3 Although recent papers suggest that the pediatric oncology population may not have higher mortality resulting from SARS-CoV-2 infection in high-income countries (Spain, 4 China, 5 USA, 6 Italy 7), these patients

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Section: Characteristic (N = 69)mentioning

confidence: 99%

COVID‐19 in pediatric cancer patients in a resource‐limited setting: National data from Peru

Montoya

Ugaz

Alarcon

et al. 2020

Pediatric Blood & Cancer

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“…Our review shows a marked reduction in paediatric ALL cases during the COVID‐19 lockdown, though the absolute numbers are small. Similarly, the Children's Hospital of Philadelphia, USA, reported no new leukaemia cases from March 02, 2020–April 06, 2020, (35 days) compared to a 5‐year average of one every 3 days, 3 and the first cases presenting in April required intensive care, indicating delayed diagnosis. The first cases of ALL at OUH in July 2020 did not show evidence of advanced disease.…”

mentioning

confidence: 98%

Observed reduction in the diagnosis of acute lymphoblastic leukaemia in children during the COVID‐19 pandemic

2020

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“…(13)The clinical course and outcome of SARS-CoV-2 was reported to be more favorable in children than in adults (1) A possible explanation that children might have less severe disease was attributed to the lower expression of ACE2 receptor and present with a different inflammatory response, with higher numbers of B and T regulator cells, involved in immune tolerance and leading to a less inflammatory immune response. (14) The detrimental impact of COVID-19 pandemic on childhood cancer may be delay in diagnosis (15), delay in starting treatment, the detrimental impact of infection on children with cancer, and the uncertainty about decision for chemotherapy in PCR-positive asymptomatic patients. Universal testing of asymptomatic cancer patients may help safe continuation of treatment.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 in Children with Cancer: A single Low-Middle income center experience

Ebeid

Ragab

Elsherif

et al. 2020

Preprint

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Background: Coronavirus disease-2019 (COVID-19) could be associated with morbidity and mortality in immunocompromised children. Objective: To measure the frequency of SARS-COV-2 infection among hospitalized children with cancer and detect the associated clinical manifestations and outcomes. Methodology: A prospective non-interventional study including all hospitalized children with cancer conducted between mid-April and mid-June 2020 in Ain Shams University hospital, Egypt. Clinical, laboratory and radiological data were collected. SARS-CoV2 infection was diagnosed by RT-PCR tests in nasopharyngeal swabs. Results: Fifteen of 61 hospitalized children with cancer were diagnosed with SARS-COV-2. Their mean age was 8.3±3.5 years. Initially, 10(66.7%) were asymptomatic and 5(33.3%) were symptomatic with fever and/or cough. Baseline laboratory tests other than SARS-COV-2 RT-PCR were not diagnostic; the mean absolute lymphocyte count was 8.7±2.4 x109/L, C-reactive protein was mildly elevated in most of patients. Imaging was performed in 10(66.7%) patients with significant radiological findings detected in 4(40%) patients. Treatment was mainly supportive with antibiotics as per the febrile neutropenia protocol and local Children Hospital guidance for management of COVID-19 in children. Conclusion: Pediatric cancer patients with COVID-19 were mainly asymptomatic or with mild symptoms. A high index of suspicion and regular screening with nasopharyngeal swab in asymptomatic hospitalized cancer patients is recommended. Introduction: Coronavirus disease 2019 (COVID-19) is a viral respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the first case was detected in December 2019. (1) The COVID-19 pandemic has rapidly escalated into a global crisis. (2) The first case registered in Egypt was in February 2020 and since that date, the numbers have been increasing and by mid-June 2020, 47,856 cases of SARS-CoV-2 and 1766 deaths have been reported by the Ministry of Health (3). Children are usually develops mild disease (4), a Chinese analysis of 2135 confirmed or suspected cases of COVID-19 among children revealed that 55.4% developed mild symptoms or were asymptomatic and only 5.4% had severe illness compared with 18.5% of adult cases. (5) Viral infections in general are associated with increased morbidity and mortality in immunocompromised children. (6) Data on the clinical features and outcomes of immunocompromised children with cancer who are infected with SARS-CoV-2 are scarce. Knowledge from previous influenza A H1N1 pandemics suggests that those vulnerable immunosuppressed children are likely to be infected and to develop manifestation as an increased number of cases are described with time. (7,8) Although isolation as an inpatient is common practice for children who are receiving intensive chemotherapy or stem cell transplant, most children with cancer are treated in the outpatient setting, and hospital visits

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Delayed cancer diagnoses and high mortality in children during the COVID‐19 pandemic

Cited by 77 publications

References 4 publications

COVID‐19 in pediatric cancer patients in a resource‐limited setting: National data from Peru

COVID‐19 in pediatric cancer patients in a resource‐limited setting: National data from Peru

Observed reduction in the diagnosis of acute lymphoblastic leukaemia in children during the COVID‐19 pandemic

COVID-19 in Children with Cancer: A single Low-Middle income center experience

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