Survival and Complications in Pediatric Patients With Cancer and COVID-19: AMeta-Analysis.

Elisa Dorantes-Acosta,Diana Ávila-Montiel,Horacio Márquez-González,Miguel Klünder-Klünder,Luis Juárez-Villegas

doi:10.3389/fonc.2020.608282

Abstract

BackgroundThe pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected all age groups, including the pediatric population, in 3–5% of all cases. We performed a meta-analysis to understand the survival and associated complications in pediatric cancer patients as well as their hospitalization, intensive care, and ventilation care (supplemental oxygen/endotracheal intubation) needs.MethodsA systematic search was performed using MEDLINE, TRIP Database, International Clinical Trials Registry Platform (WHO), The Cochrane Library, Wiley, LILACS, and Google Scholar. Additionally, a search using the snowball method was performed in Nature, New England Journal of Medicine, Science, JAMA, ELSEVIER editorial, Oxford University Press, The Lancet, and MedRxiv. Searches were conducted until July 18, 2020. A total of 191 cancer patients with coronavirus disease 2019 (COVID-19) were integrated from 15 eligible studies. In a sub-analysis, patients were stratified into two groups: hematological cancer and solid tumors. Outcome measures were overall survival, risk of hospitalized or needing intensive care, and need for ventilatory support in any modality. The random effects statistical analysis was performed with Cochran’s chi square test. The odds ratio (OR) and heterogeneity were calculated using the I2 test.ResultsThe overall survival was 99.4%. There were no statistically significant differences in the risk of hospitalization between hematological malignancies and solid tumors (95% confidence interval [CI] 0.48–18.3; OR = 2.94). The risk of being admitted to the intensive care unit was also not different between hematological malignancies and other tumors (95% CI 0.35–5.81; OR = 1.42). No differences were found for the need of ventilatory support (95% CI 0.14–3.35; OR = 0.68). Although all the studies were cross-sectional, the mortality of these patients was 0.6% at the time of analysis.ConclusionsIn the analyzed literature, survival in the studied group of patients with COVID-19 was very high. Suffering from hematological neoplasia or other solid tumors and COVID-19 was not a risk factor in children with cancer for the analyzed outcomes.

Highlights

Up to September 1, 2020, infection by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) that emerged in China, has caused 25,559,850 infections and 852,109 deaths
The severity and fatal outcomes of patients infected by SARSCoV-2 are directly related to age, as demonstrated by Zhang et al, with a higher frequency of hospitalizations, mechanical ventilation requirement, and mortality in individuals aged >60 years [2]
The exposure variable was the type of cancer, which was grouped as hematological cancer and solid tumors

Summary

Introduction

Up to September 1, 2020, infection by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) that emerged in China, has caused 25,559,850 infections and 852,109 deaths. Similar outcomes were found in New York, which was one of the main epidemic centers In this city, Richardson et al described the characteristics of 5,700 infected patients, of which systemic arterial hypertension (SAH) represented 55.6% of the comorbidities; 34 (6%) of patients were aged

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