Department of Pediatrics, Division of Pediatric Hematology-Oncology, Mount Sinai Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Pediatrics, Division of Pediatric Hematology-Oncology, Hassenfeld Children's Hospital at NYU Langone Health, Perlmutter Cancer Center, NYU Grossman School of Medicine, New York, New York.
Pediatr Blood Cancer. 2021 Mar;68(3):e28843. doi: 10.1002/pbc.28843. Epub 2020 Dec 18.
Pediatric oncology patients undergoing active chemotherapy are suspected to be at a high risk for severe disease secondary to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection; however, data to support this are lacking. We aim to describe the characteristics of coronavirus disease 2019 (COVID-19) in this population and also its impact on pediatric cancer care in the New York region during the peak of the pandemic.
This multicenter, retrospective study included 13 institutions. Clinical and laboratory information on 98 patients ≤21 years of age receiving active anticancer therapy, who tested positive for SARS-CoV-2 by nasopharyngeal swab polymerase chain reaction (PCR), was collected.
Of the 578 pediatric oncology patients tested for COVID-19, 98 were positive, of whom 73 were symptomatic. Most experienced mild disease, 28 required inpatient management, 25 needed oxygen support, and seven required mechanical ventilation. There is a slightly higher risk of severe disease in males and obese patients, though not statistically significant. Persistent lymphopenia was noted in severe cases. Delays in cancer therapy occurred in 67% of SARS-CoV-2-positive patients. Of four deaths, none were solely attributable to COVID-19. The impact of the pandemic on pediatric oncology care was significant, with 54% of institutions reporting delays in chemotherapy, 46% delays in surgery, and 30% delays in transplant.
In this large multi-institutional cohort, we observed that mortality and morbidity from COVID-19 amongst pediatric oncology patients were low overall, but higher than reported in general pediatrics. Certain subgroups might be at higher risk of severe disease. Delays in cancer care due to SARS-CoV-2 remain a concern.
正在接受积极化疗的儿科肿瘤患者疑似因严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染而患有严重疾病的高风险；然而，缺乏支持这一观点的数据。我们旨在描述这一人群中 2019 年冠状病毒病（COVID-19）的特征，以及在大流行高峰期纽约地区儿科癌症护理受到的影响。
这是一项多中心回顾性研究，包括 13 家机构。收集了 98 名接受积极抗癌治疗且鼻咽拭子聚合酶链反应（PCR）检测 SARS-CoV-2 阳性的≤21 岁儿童患者的临床和实验室信息。
在接受 COVID-19 检测的 578 名儿科肿瘤患者中，98 例呈阳性，其中 73 例有症状。大多数患者为轻症，28 例需要住院治疗，25 例需要吸氧支持，7 例需要机械通气。男性和肥胖患者患严重疾病的风险略高，但无统计学意义。严重病例中持续存在淋巴细胞减少。67%的 SARS-CoV-2 阳性患者出现癌症治疗延迟。4 例死亡中，没有一例完全归因于 COVID-19。大流行对儿科肿瘤学护理的影响显著，46%的机构报告化疗延迟，46%的机构报告手术延迟，30%的机构报告移植延迟。
在这项大型多机构队列研究中，我们观察到总体而言，儿科肿瘤患者因 COVID-19 导致的死亡率和发病率较低，但高于普通儿科报道的发病率。某些亚组可能有更高的患严重疾病风险。因 SARS-CoV-2 导致的癌症治疗延迟仍然是一个问题。
