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儿童肿瘤患者中的 SARS-CoV-2 感染:AIEOP 传染病工作组的明确综合报告。

SARS-CoV-2 Infection in the Pediatric Oncology Population: The Definitive Comprehensive Report of the Infectious Diseases Working Group of AIEOP.

机构信息

Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.

Pediatric Oncology and Hematology Department, Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliero-Universitaria di Bologna.

出版信息

J Infect Dis. 2024 Apr 12;229(4):1050-1058. doi: 10.1093/infdis/jiad496.

Abstract

OBJECTIVE

The objective of this study was to assess the clinical impact and outcome of the SARS-CoV-2 infection on children with cancer or those who received a hematopoietic stem cell transplantation.

METHODS

AIEOP (Italian Association of Pediatric Hematology and Oncology) performed a nationwide multicenter observational cohort study, including consecutive patients between April 2020 and November 2022.

RESULTS

Twenty-five Italian centers participated and 455 patients were enrolled. We reported a significant increasing trend of symptomatic cases over the years, while the number of nonmild infections remained stable. Early infection after oncologic diagnosis (<60 days) and severe neutropenia were identified as independent risk factors for developing moderate, severe, or critical infections. The percentage of patients who were asymptomatic and mildly symptomatic and who stopped chemotherapy reduced over the years of the pandemic. Nine patients died, but no death was attributed to SARS-CoV-2 infection.

CONCLUSIONS

SARS-CoV-2 infection presented a self-limiting benign course in the Italian pediatric oncohematology population during the pandemic, and its main consequence has been the discontinuation of cancer-directed therapies. The rate of patients who were asymptomatic and stopped chemotherapy reduced over the years, suggesting that the continuation of chemotherapy is a feasible option.

摘要

目的

本研究旨在评估 SARS-CoV-2 感染对癌症患儿或接受造血干细胞移植患儿的临床影响和结局。

方法

AIEOP(意大利儿科血液学和肿瘤学协会)开展了一项全国性多中心观察性队列研究,纳入了 2020 年 4 月至 2022 年 11 月期间的连续患者。

结果

25 家意大利中心参与,共纳入 455 例患者。我们报告称,症状性病例数呈逐年增加趋势,而非轻症感染数量保持稳定。肿瘤诊断后早期感染(<60 天)和严重中性粒细胞减少症被确定为发生中、重度或危重症感染的独立危险因素。无症状和轻度症状且停止化疗的患者比例在疫情期间呈逐年下降趋势。9 例患者死亡,但没有死亡归因于 SARS-CoV-2 感染。

结论

在疫情期间,SARS-CoV-2 感染在意大利儿科血液肿瘤人群中表现为自限性良性病程,其主要后果是癌症治疗的中断。无症状和停止化疗的患者比例在过去几年中有所下降,表明继续化疗是可行的选择。

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