Impact of COVID-19 on the Children with Cancer in Six Pediatric Oncology Units (POUs) of Pakistan- A Multi-Center Study

Raza, Muahammad Rafie; Maqsood, Sidra; Rana, Zulfiqar Ali; Hamid, Muhammad Haroon; Yasmeen, Nuzhat; Rehman, Mohammad Fahim ur; Iqbal, Rabia; Ashraf, Muhammad Shamvil

doi:10.1080/07357907.2021.1916027

Cited by 5 publications

(9 citation statements)

References 17 publications

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“…Twenty-four studies were conducted in LMICs, including Armenia (n=1), China (n=1), Mexico (n=1), Turkey (n=2), India (n=10), Iran (n=2), and Pakistan (n=4) ( Appendix B ). Similar to HICs, studies conducted in LMICs reported delays to chemotherapy ( 33 , 54 – 57 ), decrease in surgery rates ( 55 , 58 ), and decline in the number of new diagnoses and supportive care services offered (i.e., palliative care, psychologist, social welfare services, residential supports) ( 59 , 60 ). One comprehensive retrospective chart review by Kutluk and colleagues (2021) noted that in a major Turkish pediatric oncology department, outpatient and inpatient visits were reduced by 29.6% (p<0.0001) from March-October 2020 as compared to an analogous time period before the pandemic ( 61 ).…”

Section: Resultsmentioning

confidence: 99%

The Global Impact of COVID-19 on Childhood Cancer Outcomes and Care Delivery - A Systematic Review

et al. 2022

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BackgroundChildhood cancer represents a leading cause of death and disease burden in high income countries (HICs) and low-and-middle income countries (LMICs). It is postulated that the current COVID-19 pandemic has hampered global development of pediatric oncology care programs. This systematic review aimed to comprehensively review the global impact of COVID-19 on childhood cancer clinical outcomes and care delivery.MethodsA systematic search was conducted on PubMed, Embase, Medline, and the African Medical Index from inception to November 3, 2021 following PRISMA guidelines. A manual search was performed to identify additional relevant studies. Articles were selected based on predetermined eligibility criteria.FindingsThe majority of studies reported patients with cancer and COVID-19 presenting as asymptomatic (HICs: 33.7%, LMICs: 22.0%) or with primary manifestations of fever (HICs: 36.1%, LMICs: 51.4%) and respiratory symptoms (HICs: 29.6%, LMICs: 11.7%). LMICs also reported a high frequency of patients presenting with cough (23.6%) and gastrointestinal symptoms (10.6%). The majority of patients were generally noted to have a good prognosis; however the crude mortality rate was higher in LMICs when compared to HICs (8.0% vs 1.8%). Moreover, the pandemic has resulted in delays and interruptions to cancer therapies and delays in childhood cancer diagnoses in both HICs and LMICs. However, these findings were disproportionately reported in LMICs, with significant staff shortages, supply chain disruptions, and limited access to cancer therapies for patients.ConclusionsThe COVID-19 pandemic has resulted in delays and interruptions to childhood cancer therapies and delays in childhood cancer diagnoses, and disproportionately so within LMICs. This review provides lessons learned for future system-wide disruptions to care, as well as provides key points for moving forward better with care through the remainder of this pandemic.Systematic Review RegistrationCRD42021266758, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=266758

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Section: Resultsmentioning

confidence: 99%

The Global Impact of COVID-19 on Childhood Cancer Outcomes and Care Delivery - A Systematic Review

et al. 2022

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“…21 Early in the pandemic, different studies reported a decrease of newly diagnosed children with cancer, delays in referral to tertiary centers 7,9,22,23 and increased treatment abandonment. 7,9,15,22,23 However, by April 2021, our data show that even though one third of respondents reported persistent delays in diagnosis, only 17.3% reported treatment abandonment as a persistent problem, which might be related to an increase in the use of telemedicine as a modality to assure continuity of care. Telemedicine (including video, web and telephone-based interventions) had been implemented pre-pandemic in malignant hematologic patients; and proved to be a feasible and acceptable form of intervention.…”

Section: Resultsmentioning

confidence: 67%

“…The COVID-19 pandemic is an unprecedented global crisis that impacted pediatric cancer health care systems worldwide, with a greater effect on low and middle-income countries (LMIC). 2,3,12,[15][16][17] One year into the pandemic, the initial fears and concerns have evolved along with treatment and prevention strategies for COVID-19 and multiple effective vaccines have been developed in record time. As the pandemic continues to unfold, our 4 surveys performed over the first year of the pandemic in Latin America show the mediumterm effects on the care of pediatric cancer patients; and reveal how the medical systems and medical professionals adapted to the different health care crises that originated from the pandemic.…”

Section: Resultsmentioning

confidence: 99%

Impact of COVID-19 in pediatric oncology care in Latin America during the first year of the pandemic

Villanueva

Sampor²,

Palma

et al. 2022

Preprint

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The ongoing COVID-19 pandemic strained medical systems worldwide. We report on the impact on pediatric oncology care in Latin American (LATAM) during its first year. Four cross-sectional surveys were electronically distributed among pediatric onco-hematologist in April/June/October 2020, and April/2021 through the Latin American Society of Pediatric Oncology (SLAOP) email list and St Jude Global regional partners. 453 pediatric onco-hematologists from 20 countries responded the first survey with subsequent surveys response rates above 85%. More than 95% of participants reported that treatment continued without interruption for new and active on-going patients, though with disruptions in treatment availability. During the first three surveys, respondents reported suspensions of outpatient procedures (54.2%), a decrease in oncologic surgeries (43.6%), radiotherapy (28.4%), stem cell transplants (SCT) (69.3%), and surveillance consultations (81.2%). Logistic regression analysis showed that at the beginning of the first wave, participants from countries with healthcare expenditure below 7% were more likely to report a decrease in outpatient procedures (OR:1.84, 95%C:1.19;2.8), surgeries (OR:3, 95%CI:1.9;4.6) and radiotherapy (OR:6, 95%CI:3.5;10.4). Suspension of surveillance consultations was higher in countries with COVID-19 case fatality rates above 2% (OR:3, 95%CI:1.4;6.2) and SCT suspensions in countries with COVID-19 incidence rate above 100 cases per 100,000 (OR:3.48, 95%CI:1.6;7.45). Paradoxically, at the beginning of the second wave with COVID-19 cases rising exponentially, most participants reported improvements in cancer services availability. Our data show the medium-term collateral effects of the pandemic on pediatric oncology care in LATAM, which might help delineate oncology care delivery amid current and future challenges posed by the pandemic.

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“…We screened a total of 2759 records after transferring the databases results without duplicates. We further assessed 61 full texts for eligibility which ended up with a total of 21 articles including 14 studies and additional seven studies following manual search procedures 7 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 (Figure 1 , Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

COVID‐19 outcomes in paediatric cancer: A large scale pooled meta‐analysis of 984 cancer patients

El‐Qushayri

Benmelouka²,

Dahy

et al. 2022

Reviews in Medical Virology

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We aimed to study the outcomes of COVID‐19 in paediatric cancer patients. On 26 October 2021, we did a systematic search for relevant articles in seven electronic databases followed by manual search. We included cancer patients aged ≤18 years. Event rates and the 95% confidence interval (95%CI) were used to report the results. We included 21 papers after screening of 2759 records. The pooled rates of hospitalisation, intensive care unit (ICU) admission and mortality were 44% (95%CI: 30–59), 14% (95%CI: 9–21) and 9% (95%CI: 6–12), respectively. Moreover, subgroup analysis revealed that high income countries had better COVID‐19 outcomes compared to upper middle income countries and lower middle income countries in terms of hospitalisation 30% (95%CI: 17–46), 60% (95%CI: 29–84) and 47% (95%CI: 36–58), ICU admission 7% (95%CI: 1–32), 13% (95%CI: 7–23) and 18% (95%CI: 6–41), and mortality 3% (95%CI: 2–5), 12% (95%CI: 8–18) and 13% (95%CI: 8–20), in order. In general, absence of specific pharmacologic intervention to prevent infection with the scarcity of vaccination coverage data among paediatric groups and its impact, high priority caution is required to avoid SARS‐CoV‐2 infection among paediatric cancer patients. Furthermore, our results highlight the importance of promoting care facilities for this vulnerable population in low and middle income regions to ensure quality care among cancer patients during pandemic crisis.

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Impact of COVID-19 on the Children with Cancer in Six Pediatric Oncology Units (POUs) of Pakistan- A Multi-Center Study

Cited by 5 publications

References 17 publications

The Global Impact of COVID-19 on Childhood Cancer Outcomes and Care Delivery - A Systematic Review

The Global Impact of COVID-19 on Childhood Cancer Outcomes and Care Delivery - A Systematic Review

Impact of COVID-19 in pediatric oncology care in Latin America during the first year of the pandemic

COVID‐19 outcomes in paediatric cancer: A large scale pooled meta‐analysis of 984 cancer patients

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