Abstract
Abstract Objectives: to describe epidemiological characteristics and deaths in children with cancer and COVID-19 at a reference hospital in Recife, Brazil. Methods: cohort involving children under the age of 19 underwent cancer treatment during April to July 2020. During the pandemic, real-time reverse transcriptase polymerase chain reaction assay (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS -CoV-2) in nasal / oropharyngeal swab were collected in symptomatic patients or before hospitalization. Those with detectable results were included in this cohort study. The outcomes were delayed on cancer treatment and death. Descriptive analysis was performed and presented in preliminary results. Results: 48 children participated in the cohort, mostly with hematological neoplasms (66.6%.),69% were male, median age was 5.5 years. The most frequent symptoms were fever (58.3%) and coughing (27.7%);72.9% required hospitalization, 20% had support in ICU and 10.5% on invasive ventilatory assistance.66.6% of the patients had their oncological treatment postponed, 16.6% died within 60 days after confirmation of SARS-CoV-2 infection. Conclusions: COVID-19 led a delay in the oncological treatment for children with cancer and a higher mortality frequency when compared to the historical series of the service. It would be important to analyze the risk factors to determine the survival impact.
Highlights
Adult cancer patients infected with the severe acute respiratory virus coronavirus 2 (SARS-CoV-2) tend to have more severe clinical outcomes when compared to non-oncologic patients, highlighting the hematological, lung and metastatic cancers stages.[1]
Despite the lack of data, recent articles suggest that the morbidity of the new coronavirus 2019 disease (COVID-19) in pediatric patients with cancer is low, and that these patients are no longer vulnerable to SARS-CoV-2 infection when compared to children without comorbidities.[2,3]
In addition to the concern with SARS-CoV-2 infection in children with cancer, there is a fear of delay in the diagnosis and treatment of these patients due to the difficulties caused by the pandemic.[9]
Summary
Adult cancer patients infected with the severe acute respiratory virus coronavirus 2 (SARS-CoV-2) tend to have more severe clinical outcomes when compared to non-oncologic patients, highlighting the hematological, lung and metastatic cancers stages.[1]. Children get less sick, that is, they have less susceptibility and when they become infected, there is a predominance of asymptomaticor mild cases, so it is less severe.[4,5,6] The most common symptoms in the acute phase are coughing and fever, and a minority needs hospitalization and support in the intensive care unit (ICU), with a complication rate of less than 2%. Cases of greater severity called multi-systemic inflammatory syndrome associated with COVID-19 (SIM-C) have been described and are considered a late complication in the pediatric age group.[7]. Most pediatric cancers behave aggressively, requiring immediate treatment and may need long periods of intensive chemotherapy with multiple antineoplastic agents.[8] In contrast, they respond better to the treatment and are considered of good prognosis when compared to adults. In addition to the concern with SARS-CoV-2 infection in children with cancer, there is a fear of delay in the diagnosis and treatment of these patients due to the difficulties caused by the pandemic.[9]
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