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ALL-098: COVID-19 in Children with Cancer: What We Learned from the First Wave
CONTEXT: COVID-19 is associated with morbidity and mortality in children with cancer, who are treated mainly in outpatient settings, where hospital visits are unavoidable for appropriate delivery of therapy, increasing their exposure risk to SARS-CoV-2. OBJECTIVE: To measure the frequency of SARS-Co...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8404077/ http://dx.doi.org/10.1016/S2152-2650(21)01649-9 |
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author | Ebeid, Fatma Adly, Amira Makkeyah, Sara Mostafa, Salwa Ragab, Iman |
author_facet | Ebeid, Fatma Adly, Amira Makkeyah, Sara Mostafa, Salwa Ragab, Iman |
author_sort | Ebeid, Fatma |
collection | PubMed |
description | CONTEXT: COVID-19 is associated with morbidity and mortality in children with cancer, who are treated mainly in outpatient settings, where hospital visits are unavoidable for appropriate delivery of therapy, increasing their exposure risk to SARS-CoV-2. OBJECTIVE: To measure the frequency of SARS-CoV-2 infection among hospitalized children with cancer and to detect the associated clinical manifestations and outcomes. DESIGN: A prospective, nonintervention study recruited all hospitalized children with cancer with confirmed SARS-CoV-2 between mid-April and mid-June 2020 (NCT04404244). SETTING: The study was carried out at a tertiary Pediatric Hematology Oncology Department at Ain Shams University in Egypt. METHODOLOGY: On admission and upon suspicion of COVID-19, patient clinical report forms, including demographic data, clinical assessments, epidemiological data (history of contact with a COVID-19 case), underlying oncologic disorders, and cause of admission, were completed. Baseline laboratory investigations, including complete blood count, C-reactive protein, serum ferritin, lactate dehydrogenase, and D-dimer, were performed. COVID-19 was confirmed by SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test by nasopharyngeal swab. Chest radiograph and/or high-resolution computed tomography (HRCT) chest scan was performed. RESULTS: Over the study course, 61 children with cancer were admitted: 42 (68.9%) had acute lymphoblastic leukemia (ALL), 4 (6.5%) had lymphoma, and 15 patients had other malignancy. Fifteen were diagnosed with SARS-CoV-2. Most had hematological malignancies: 10 (76.9%) had ALL, 1 (6.7%) had acute myeloid leukemia, and 2 (13.4%) had lymphoma. 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 × 10(9)/L. C-reactive protein was mildly elevated in most of the patients. Imaging was performed in 10 (66.7%) patients, with significant radiologic findings detected in 4 (40%) patients. Treatment was mainly supportive with antibiotics, as per the febrile neutropenia protocol and local Children’s Hospital guidance for management of COVID-19 in children. CONCLUSIONS: Pediatric cancer patients with COVID-19 were mainly asymptomatic or with mild symptoms. A high index of suspicion and regular screening with nasopharyngeal swabs in asymptomatic hospitalized cancer patients is recommended. |
format | Online Article Text |
id | pubmed-8404077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84040772021-08-30 ALL-098: COVID-19 in Children with Cancer: What We Learned from the First Wave Ebeid, Fatma Adly, Amira Makkeyah, Sara Mostafa, Salwa Ragab, Iman Clin Lymphoma Myeloma Leuk Article CONTEXT: COVID-19 is associated with morbidity and mortality in children with cancer, who are treated mainly in outpatient settings, where hospital visits are unavoidable for appropriate delivery of therapy, increasing their exposure risk to SARS-CoV-2. OBJECTIVE: To measure the frequency of SARS-CoV-2 infection among hospitalized children with cancer and to detect the associated clinical manifestations and outcomes. DESIGN: A prospective, nonintervention study recruited all hospitalized children with cancer with confirmed SARS-CoV-2 between mid-April and mid-June 2020 (NCT04404244). SETTING: The study was carried out at a tertiary Pediatric Hematology Oncology Department at Ain Shams University in Egypt. METHODOLOGY: On admission and upon suspicion of COVID-19, patient clinical report forms, including demographic data, clinical assessments, epidemiological data (history of contact with a COVID-19 case), underlying oncologic disorders, and cause of admission, were completed. Baseline laboratory investigations, including complete blood count, C-reactive protein, serum ferritin, lactate dehydrogenase, and D-dimer, were performed. COVID-19 was confirmed by SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test by nasopharyngeal swab. Chest radiograph and/or high-resolution computed tomography (HRCT) chest scan was performed. RESULTS: Over the study course, 61 children with cancer were admitted: 42 (68.9%) had acute lymphoblastic leukemia (ALL), 4 (6.5%) had lymphoma, and 15 patients had other malignancy. Fifteen were diagnosed with SARS-CoV-2. Most had hematological malignancies: 10 (76.9%) had ALL, 1 (6.7%) had acute myeloid leukemia, and 2 (13.4%) had lymphoma. 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 × 10(9)/L. C-reactive protein was mildly elevated in most of the patients. Imaging was performed in 10 (66.7%) patients, with significant radiologic findings detected in 4 (40%) patients. Treatment was mainly supportive with antibiotics, as per the febrile neutropenia protocol and local Children’s Hospital guidance for management of COVID-19 in children. CONCLUSIONS: Pediatric cancer patients with COVID-19 were mainly asymptomatic or with mild symptoms. A high index of suspicion and regular screening with nasopharyngeal swabs in asymptomatic hospitalized cancer patients is recommended. Elsevier Inc. 2021-09 2021-08-30 /pmc/articles/PMC8404077/ http://dx.doi.org/10.1016/S2152-2650(21)01649-9 Text en Copyright © 2021 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Ebeid, Fatma Adly, Amira Makkeyah, Sara Mostafa, Salwa Ragab, Iman ALL-098: COVID-19 in Children with Cancer: What We Learned from the First Wave |
title | ALL-098: COVID-19 in Children with Cancer: What We Learned from the First Wave |
title_full | ALL-098: COVID-19 in Children with Cancer: What We Learned from the First Wave |
title_fullStr | ALL-098: COVID-19 in Children with Cancer: What We Learned from the First Wave |
title_full_unstemmed | ALL-098: COVID-19 in Children with Cancer: What We Learned from the First Wave |
title_short | ALL-098: COVID-19 in Children with Cancer: What We Learned from the First Wave |
title_sort | all-098: covid-19 in children with cancer: what we learned from the first wave |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8404077/ http://dx.doi.org/10.1016/S2152-2650(21)01649-9 |
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