Hernández-Regino Laura-Monserrat, De Jesús Castillejos-López Manuel, Aquino-Gálvez Arnoldo, Velasco-Hidalgo Liliana, García-Guzmán Alda, Aguilar-Ortiz Marco, Cárdenas-Cardos Rocío, Torres-Espíndola Luz María
Laboratory of Pharmacology, National Institute of Pediatrics, Mexico City, Mexico.
Department of Hospital Epidemiology and Infectology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico.
Front Pediatr. 2022 Jul 28;10:960334. doi: 10.3389/fped.2022.960334. eCollection 2022.
More than 135 million COVID-19 cases (coronavirus disease 2019) have been reported worldwide until today, with over 2.9 million deaths. Several studies have demonstrated that disease severity is lower in the pediatric population than in adults; however, differences are described in patients with chronic diseases, including oncological patients. Current world literature suggests patients with comorbidities, including cancer, have an increased risk of unfortunate outcomes. Therefore, our objective was to describe the clinical characteristics and epidemiological factors associated with mortality in a cohort of pediatric cancer patients hospitalized for COVID-19.
This is a retrospective, descriptive study of the cases of patients with cancer hospitalized for COVID-19. A total of 40 pediatrics were included in the analysis. Data from pediatric patients with COVID-19 included clinical and epidemiological records, laboratory, imaging studies, COVID-19 diagnostic methods, and medical treatment.
Of the 40 pediatric patients admitted with cancer with a confirmed diagnosis of COVID-19, 42.5% were solid tumors, 40% leukemias, and 17.5% lymphomas. The clinical parameters associated with mortality were stage IV tumor ( = 0.029) and intubation ( < 0.001). The biochemical factors associated with lower survival were thrombocytopenia under 25,000 cells/mm ( < 0.001), D-dimer over 1 μg/ml ( = 0.003), clinical malnutrition ( = 0.023), and disseminated intravascular coagulation ( = 0.03).
Our findings showed that the fever was the most frequent symptom, and the clinical parameters associated with mortality were stage IV tumor, intubation, saturation percentage, RDW, platelets, creatinine, ALT, D-dimer, ferritin, and FiO2 percentage. The thrombocytopenia, D-dimer, nutritional status, and disseminated intravascular coagulation were significantly associated with lower survival.
截至今日，全球已报告超过1.35亿例2019冠状病毒病（COVID-19）病例，死亡人数超过290万。多项研究表明，儿科人群的疾病严重程度低于成人；然而，在包括肿瘤患者在内的慢性病患者中存在差异。当前世界文献表明，包括癌症在内的合并症患者出现不良结局的风险增加。因此，我们的目标是描述因COVID-19住院的儿科癌症患者队列中与死亡率相关的临床特征和流行病学因素。
这是一项对因COVID-19住院的癌症患者病例的回顾性描述性研究。共有40名儿科患者纳入分析。COVID-19儿科患者的数据包括临床和流行病学记录、实验室检查、影像学研究、COVID-19诊断方法及治疗情况。
在确诊为COVID-19的40例癌症住院儿科患者中，42.5%为实体瘤，40%为白血病，17.5%为淋巴瘤。与死亡率相关的临床参数为IV期肿瘤（P = 0.029）和插管（P < 0.001）。与较低生存率相关的生化因素为血小板计数低于25000个/立方毫米（P < 0.001）、D-二聚体超过1微克/毫升（P = 0.003）、临床营养不良（P = 0.023）及弥散性血管内凝血（P = 0.03）。
我们的研究结果表明，发热是最常见的症状，与死亡率相关的临床参数为IV期肿瘤、插管、血氧饱和度、红细胞分布宽度、血小板、肌酐、谷丙转氨酶、D-二聚体、铁蛋白及吸氧浓度百分比。血小板减少、D-二聚体、营养状况及弥散性血管内凝血与较低生存率显著相关。
