Clinical Outcomes of Pediatric Cancer Patients with COVID-19: A Cross-Sectional Study
Pediatric Patients with Cancer and COVID-19
-
Yasaman Arian
,
Pooya Faranoush
,
Fahime Ehsanipour
,
Negin Sadighnia
,
Ali Elahinia
,
Mohammad Faranoush
Abstract
Background: Considering the widespread COVID-19 pandemic and its impact, especially on children, particularly those with cancer, in terms of transmission risk, mortality, and the occurrence of the disease based on various studies in different countries, we decided to conduct this study to improve the care of children with cancer regarding COVID-19.
Materials and Methods: A descriptive cross-sectional study with a confirmed diagnosis of COVID-19 consisted of obtaining 20 mL of blood samples from the participants in a random manner. Diagnostic examinations, including CT scans, chest X-rays, and a range of hematologic and blood tests, such as complete blood count, ESR, CRP, and D-Dimer, were performed on all patients.
Results: This study contains 26 males and 12 females. The mean age of the patients was 3.81 ± 6.35 years. The majority of cancer patients with COVID-19 were diagnosed with Acute Lymphoblastic Leukemia (ALL) (47.7%). The most common symptoms of COVID-19 in the patients were fever (73.7%), cough (39.5%), and nausea/vomiting (21.1%). 40.4% of the patients had pathological findings suggestive of COVID-19 on their chest CT scans. 60.52% of the patients had an elevated Erythrocyte Sedimentation Rate (ESR), and 73.68% had an elevated C-reactive protein (CRP) level.
Conclusion: Despite the outcomes of COVID-19 in most children with cancer in this study, children with cancer still experience risks from COVID-19, and it is unclear how delays and interruptions in cancer treatment and direct damage from the virus may impact long-term outcomes in these patients.
REFERENCES
1. Hu T, Liu Y, Zhao M, et al. A comparison of COVID-19, SARS and MERS. PeerJ. 2020;8:e9725.
2. Cao Y, Yang R, Lee I, et al. Characterization of the SARS-CoV-2 E Protein: Sequence, Structure, Viroporin, and Inhibitors. Protein Sci. 2021;30(6):1114-30.
3. Gheblawi M, Wang K, Viveiros A, et al. Angiotensin-Converting Enzyme 2: SARS-CoV-2 Receptor and Regulator of the Renin-Angiotensin System: Celebrating the 20th Anniversary of the Discovery of ACE2. Circ Res. 2020;126(10):1456-74.
4. Zarebavani M, Baghaei Naeini F, Farahvash A, et al. Resveratrol attenuates chronic social isolation stress‐induced affective disorders: Involvement of NF‐κB/NLRP3 axis. J Biochem Mol Toxicol. 2023;37(5):e23311.
5. Naeini FB, Hassanpour S, Asghari A. Resveratrol exerts anxiolytic-like effects through anti-inflammatory and antioxidant activities in rats exposed to chronic social isolation. Behav Brain Res. 2023;438:114201.
6. covid19treatmentguidelines 2023 [Available from: https://www.covid19treatmentguidelines.nih.gov/.
7. Çelik I, Öztürk R. From asymptomatic to critical illness: decoding various clinical stages of COVID-19. Turk J Med Sci. 2021;51(SI-1):3284-300.
8. Vidya G, Kalpana M, Roja K, et al. Pathophysiology and Clinical Presentation of COVID-19 in Children: Systematic Review of the Literature. Maedica (Bucur). 2021;16(3):499-506.
9. Chow EJ, Englund JA. Severe Acute Respiratory Syndrome Coronavirus 2 Infections in Children. Infect Dis Clin North Am. 2022;36(2):435-79.
10. Zhu F, Ang JY. COVID-19 Infection in Children: Diagnosis and Management. Curr Infect Dis Rep. 2022;24(4):51-62.
11. Khalaji A, Yancheshmeh FB, Farham F, et al. Don't eat me/eat me signals as a novel strategy in cancer immunotherapy. Heliyon. 2023;9(10):e20507.
12. Tahavvori A, Alizadeh F, Mousavian A, et al. Achievements, Challenges, And Limitations Of Car-T Cell Therapy In Cancer Treatment, A Comprehensive Review. J Pharm Negat Results. 2022: 13(9):11145-52.
13. Farrokhi M, Taheri F, Farrokhi M, Heydari Z, et al. advancements in the management of pediatric cancers. In Faranoush P (ed). Advancements and Innovations in Cancer Management: A Comprehensive Perspective. Zenodo, USA, 2024. pp 24-31.
14. Revon-Riviere G, Ninove L, Min V, et al. The BNT162b2 mRNA COVID-19 vaccine in adolescents and young adults with cancer: A monocentric experience. Eur J Cancer. 2021; 154: 30–34.
15. Terrance B, Greiner JV, Maxwell-Schmidt E, et al. Guidelines for Frontline Health Care Staff Safety for COVID-19. J Prim Care Community Health. 2020; 11: 2150132720938046.
16. Charla Y, Kalra M, Chopra N, et al. COVID-19 vaccination in pediatric cancer patients: A high priority. Pediatr Blood Cancer. 2021;68(12):e29397.
17. Smart M, Puopolo O, Chang MR, et al. Clinical course and native antibody development after COVID-19 infection in 50 pediatric oncology patients. J Clin Oncol. 2023;41(16_suppl):10063.
18. Hasnat F, Noman F, Moben AL, et al. Difference in Clinical Patterns between COVID-19 Affected Children and Adults. Mymensingh Med J. 2021;30(4):1093-1099.
19. Tran A, Hou SHJ, Forbes C, et al. The Impact of the Early COVID-19 Global Pandemic on Children Undergoing Active Cancer Treatment and Their Parents. Curr Oncol. 2023;30(2):2441-56.
20. Millen GC, Arnold R, Cazier JB, et al. Severity of COVID-19 in children with cancer: report from the United Kingdom Paediatric Coronavirus Cancer Monitoring Project. Br J Cancer. 2021;124(4):754-759.
21. Boulad F, Kamboj M, Bouvier N, et al. COVID-19 in children with cancer in New York City. JAMA Oncol. 2020;6(9):1459-1460.
22. Gampel B, Lucas AGT, Broglie L, et al. COVID‐19 disease in New York City pediatric hematology and oncology patients. Pediatr Blood Cancer. 2020;67(9):e28420.
23. Schlage S, Lehrnbecher T, Berner R, et al. SARS-CoV-2 in pediatric cancer: a systematic review. Eur J Pediatr. 2022;181(4):1413-1427.
24. Navaeian A, Mahmoudi S, Pourakbari B, et al. COVID-19 infection in children with underlying malignancies in Iran. J Basic Clin Physiol Pharmacol. 2021;33(1):79-84.
25. Madhusoodhan PP, Pierro J, Musante J, et al. Characterization of COVID‐19 disease in pediatric oncology patients: the New York‐New Jersey regional experience. Pediatr Blood Cancer. 2021;68(3):e28843.
26. Mehrvar A, Qaddoumi I, Tashvighi M, et al. Treatment and outcomes of pediatric patients with cancer and COVID-19 at MAHAK pediatric cancer treatment and research center, Tehran, Iran. Semin Oncol. 2021;48(4-6):295-303.
27. Armin S, Mirkarimi M, Pourmoghaddas Z, et al. Iranian Pediatric COVID-19 Epidemiology and Clinical Characteristics. Can J Infect Dis Med Microbiol. 2021;2021:4914371.
28. COVID-19 and Childhood Cancer Registry [Internet]. St. Jude Global. [cited 2021 Sep 14]. Available from: https://global.stjude.org/en-us/global-covid-19-observatory-and-resource-center-for-childhood-cancer/registry.html.
29. Johnston EE LJ, Kahn A, Sharma A, Schwalm C, Brackett J, et al. reports and updates 2023 [cited 2023. Available from: https://www.uab.edu/medicine/icos/icos-research/the-pocc-report/reports-updates.
30. de Rojas T, Pérez-Martínez A, Cela E, et al. COVID-19 infection in children and adolescents with cancer in Madrid. Pediatr Blood Cancer. 2020;67(7):e28397.
31. Kahn AR, Schwalm CM, Wolfson JA, et al. COVID-19 in Children with Cancer. Curr Oncol Rep. 2022;24(3):295-302.
32. Patel NA. Pediatric COVID-19: Systematic review of the literature. Am J Otolaryngol. 2020;41(5):102573.
33. Meena J, Yadav J, Saini L, et al. Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis. Indian Pediatr. 2020;57(9):820-826.
34. Gallo Marin B, Aghagoli G, Lavine K, et al. Predictors of COVID‐19 severity: a literature review. Rev Med Virol. 2021;31(1):1-10.
35. Badal S, Bajgain KT, Badal S, et al. Prevalence, clinical characteristics, and outcomes of pediatric COVID-19: a systematic review and meta-analysis. J Clin Virol. 2021;135:104715.
36. Kara AA, Böncüoğlu E, Kıymet E, et al. Evaluation of predictors of severe-moderate COVID-19 infections at children: A review of 292 children. J Med Virol. 2021;93(12):6634-6640.
37. Nooh HA, Abdellateif MS, Refaat L, et al. The role of inflammatory indices in the outcome of COVID-19 cancer patients. Med Oncol. 2021;39(1):6.
38. Amicucci M, Mastronuzzi A, Ciaralli I, et al. The Management of Children with Cancer during the COVID-19 Pandemic: A Rapid Review. J Clin Med. 2020;9(11):3756.
39. Minotti C, Tirelli F, Barbieri E, et al. How is immunosuppressive status affecting children and adults in SARS-CoV-2 infection? A systematic review. J Infect. 2020;81(1):e61-e66.
40. Arous R, Djillali IS, Rouis NO, et al. High mortality of COVID-19 in children with cancer in a single center in Algiers, Algeria. Pediatr Blood Cancer. 2021;68(6):e28898.
41. Hrusak O, Kalina T, Wolf J, et al. Flash survey on severe acute respiratory syndrome coronavirus-2 infections in paediatric patients on anticancer treatment. Eur J Cancer. 2020;132:11-16.
42. Hammad M, Shalaby L, Sidhom I, et al. Management and Outcome of Coronavirus Disease 2019 (COVID-19) in Pediatric Cancer Patients: A Single Centre Experience from a Developing Country. Clin Lymphoma Myeloma Leuk. 2021;21(11):e853-e864.
43. Orf K, Rogosic S, Dexter D, et al. Remdesivir during induction chemotherapy for newly diagnosed paediatric acute lymphoblastic leukaemia with concomitant SARS-CoV-2 infection. Br J Haematol. 2020;190(5):e274-e276.
44. Hashemieh M. Preventive Strategies for Cancer Patients during COVID-19 Pandemic: A Review. Int J Pediatr. 2021;9(2):12981-12987.
45. Ferrari A, Zecca M, Rizzari C, et al. Children with cancer in the time of COVID‐19: An 8‐week report from the six pediatric onco‐hematology centers in Lombardia, Italy. Pediatr Blood Cancer. 2020;67(8):e28410.
46. André N, Rouger‐Gaudichon J, Brethon B, et al. COVID‐19 in pediatric oncology from French pediatric oncology and hematology centers: High risk of severe forms? Pediatr Blood Cancer. 2020;67(7):e28392.
47. Dorantes-Acosta E, Avila-Montiel D, Klünder-Klünder M, et al. Survival and complications in pediatric patients with cancer and COVID-19: a meta-analysis. Front Oncol. 2021;10:608282.
48. Mukkada S, Bhakta N, Chantada GL, et al. Global characteristics and outcomes of SARS-CoV-2 infection in children and adolescents with cancer (GRCCC): a cohort study. Lancet Oncol. 2021;22(10):1416-1426.
49. Faranoush P, Jahandideh A, Nekouian R, et al. Evaluation of the in vitro and in vivo effect of liposomal doxorubicin along with oncolytic Newcastle disease virus on 4T1 cell line: Animal preclinical research. Vet Med Sci. 2023;9(3):1426-1437.
1. Hu T, Liu Y, Zhao M, et al. A comparison of COVID-19, SARS and MERS. PeerJ. 2020;8:e9725.
2. Cao Y, Yang R, Lee I, et al. Characterization of the SARS-CoV-2 E Protein: Sequence, Structure, Viroporin, and Inhibitors. Protein Sci. 2021;30(6):1114-30.
3. Gheblawi M, Wang K, Viveiros A, et al. Angiotensin-Converting Enzyme 2: SARS-CoV-2 Receptor and Regulator of the Renin-Angiotensin System: Celebrating the 20th Anniversary of the Discovery of ACE2. Circ Res. 2020;126(10):1456-74.
4. Zarebavani M, Baghaei Naeini F, Farahvash A, et al. Resveratrol attenuates chronic social isolation stress‐induced affective disorders: Involvement of NF‐κB/NLRP3 axis. J Biochem Mol Toxicol. 2023;37(5):e23311.
5. Naeini FB, Hassanpour S, Asghari A. Resveratrol exerts anxiolytic-like effects through anti-inflammatory and antioxidant activities in rats exposed to chronic social isolation. Behav Brain Res. 2023;438:114201.
6. covid19treatmentguidelines 2023 [Available from: https://www.covid19treatmentguidelines.nih.gov/.
7. Çelik I, Öztürk R. From asymptomatic to critical illness: decoding various clinical stages of COVID-19. Turk J Med Sci. 2021;51(SI-1):3284-300.
8. Vidya G, Kalpana M, Roja K, et al. Pathophysiology and Clinical Presentation of COVID-19 in Children: Systematic Review of the Literature. Maedica (Bucur). 2021;16(3):499-506.
9. Chow EJ, Englund JA. Severe Acute Respiratory Syndrome Coronavirus 2 Infections in Children. Infect Dis Clin North Am. 2022;36(2):435-79.
10. Zhu F, Ang JY. COVID-19 Infection in Children: Diagnosis and Management. Curr Infect Dis Rep. 2022;24(4):51-62.
11. Khalaji A, Yancheshmeh FB, Farham F, et al. Don't eat me/eat me signals as a novel strategy in cancer immunotherapy. Heliyon. 2023;9(10):e20507.
12. Tahavvori A, Alizadeh F, Mousavian A, et al. Achievements, Challenges, And Limitations Of Car-T Cell Therapy In Cancer Treatment, A Comprehensive Review. J Pharm Negat Results. 2022: 13(9):11145-52.
13. Farrokhi M, Taheri F, Farrokhi M, Heydari Z, et al. advancements in the management of pediatric cancers. In Faranoush P (ed). Advancements and Innovations in Cancer Management: A Comprehensive Perspective. Zenodo, USA, 2024. pp 24-31.
14. Revon-Riviere G, Ninove L, Min V, et al. The BNT162b2 mRNA COVID-19 vaccine in adolescents and young adults with cancer: A monocentric experience. Eur J Cancer. 2021; 154: 30–34.
15. Terrance B, Greiner JV, Maxwell-Schmidt E, et al. Guidelines for Frontline Health Care Staff Safety for COVID-19. J Prim Care Community Health. 2020; 11: 2150132720938046.
16. Charla Y, Kalra M, Chopra N, et al. COVID-19 vaccination in pediatric cancer patients: A high priority. Pediatr Blood Cancer. 2021;68(12):e29397.
17. Smart M, Puopolo O, Chang MR, et al. Clinical course and native antibody development after COVID-19 infection in 50 pediatric oncology patients. J Clin Oncol. 2023;41(16_suppl):10063.
18. Hasnat F, Noman F, Moben AL, et al. Difference in Clinical Patterns between COVID-19 Affected Children and Adults. Mymensingh Med J. 2021;30(4):1093-1099.
19. Tran A, Hou SHJ, Forbes C, et al. The Impact of the Early COVID-19 Global Pandemic on Children Undergoing Active Cancer Treatment and Their Parents. Curr Oncol. 2023;30(2):2441-56.
20. Millen GC, Arnold R, Cazier JB, et al. Severity of COVID-19 in children with cancer: report from the United Kingdom Paediatric Coronavirus Cancer Monitoring Project. Br J Cancer. 2021;124(4):754-759.
21. Boulad F, Kamboj M, Bouvier N, et al. COVID-19 in children with cancer in New York City. JAMA Oncol. 2020;6(9):1459-1460.
22. Gampel B, Lucas AGT, Broglie L, et al. COVID‐19 disease in New York City pediatric hematology and oncology patients. Pediatr Blood Cancer. 2020;67(9):e28420.
23. Schlage S, Lehrnbecher T, Berner R, et al. SARS-CoV-2 in pediatric cancer: a systematic review. Eur J Pediatr. 2022;181(4):1413-1427.
24. Navaeian A, Mahmoudi S, Pourakbari B, et al. COVID-19 infection in children with underlying malignancies in Iran. J Basic Clin Physiol Pharmacol. 2021;33(1):79-84.
25. Madhusoodhan PP, Pierro J, Musante J, et al. Characterization of COVID‐19 disease in pediatric oncology patients: the New York‐New Jersey regional experience. Pediatr Blood Cancer. 2021;68(3):e28843.
26. Mehrvar A, Qaddoumi I, Tashvighi M, et al. Treatment and outcomes of pediatric patients with cancer and COVID-19 at MAHAK pediatric cancer treatment and research center, Tehran, Iran. Semin Oncol. 2021;48(4-6):295-303.
27. Armin S, Mirkarimi M, Pourmoghaddas Z, et al. Iranian Pediatric COVID-19 Epidemiology and Clinical Characteristics. Can J Infect Dis Med Microbiol. 2021;2021:4914371.
28. COVID-19 and Childhood Cancer Registry [Internet]. St. Jude Global. [cited 2021 Sep 14]. Available from: https://global.stjude.org/en-us/global-covid-19-observatory-and-resource-center-for-childhood-cancer/registry.html.
29. Johnston EE LJ, Kahn A, Sharma A, Schwalm C, Brackett J, et al. reports and updates 2023 [cited 2023. Available from: https://www.uab.edu/medicine/icos/icos-research/the-pocc-report/reports-updates.
30. de Rojas T, Pérez-Martínez A, Cela E, et al. COVID-19 infection in children and adolescents with cancer in Madrid. Pediatr Blood Cancer. 2020;67(7):e28397.
31. Kahn AR, Schwalm CM, Wolfson JA, et al. COVID-19 in Children with Cancer. Curr Oncol Rep. 2022;24(3):295-302.
32. Patel NA. Pediatric COVID-19: Systematic review of the literature. Am J Otolaryngol. 2020;41(5):102573.
33. Meena J, Yadav J, Saini L, et al. Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis. Indian Pediatr. 2020;57(9):820-826.
34. Gallo Marin B, Aghagoli G, Lavine K, et al. Predictors of COVID‐19 severity: a literature review. Rev Med Virol. 2021;31(1):1-10.
35. Badal S, Bajgain KT, Badal S, et al. Prevalence, clinical characteristics, and outcomes of pediatric COVID-19: a systematic review and meta-analysis. J Clin Virol. 2021;135:104715.
36. Kara AA, Böncüoğlu E, Kıymet E, et al. Evaluation of predictors of severe-moderate COVID-19 infections at children: A review of 292 children. J Med Virol. 2021;93(12):6634-6640.
37. Nooh HA, Abdellateif MS, Refaat L, et al. The role of inflammatory indices in the outcome of COVID-19 cancer patients. Med Oncol. 2021;39(1):6.
38. Amicucci M, Mastronuzzi A, Ciaralli I, et al. The Management of Children with Cancer during the COVID-19 Pandemic: A Rapid Review. J Clin Med. 2020;9(11):3756.
39. Minotti C, Tirelli F, Barbieri E, et al. How is immunosuppressive status affecting children and adults in SARS-CoV-2 infection? A systematic review. J Infect. 2020;81(1):e61-e66.
40. Arous R, Djillali IS, Rouis NO, et al. High mortality of COVID-19 in children with cancer in a single center in Algiers, Algeria. Pediatr Blood Cancer. 2021;68(6):e28898.
41. Hrusak O, Kalina T, Wolf J, et al. Flash survey on severe acute respiratory syndrome coronavirus-2 infections in paediatric patients on anticancer treatment. Eur J Cancer. 2020;132:11-16.
42. Hammad M, Shalaby L, Sidhom I, et al. Management and Outcome of Coronavirus Disease 2019 (COVID-19) in Pediatric Cancer Patients: A Single Centre Experience from a Developing Country. Clin Lymphoma Myeloma Leuk. 2021;21(11):e853-e864.
43. Orf K, Rogosic S, Dexter D, et al. Remdesivir during induction chemotherapy for newly diagnosed paediatric acute lymphoblastic leukaemia with concomitant SARS-CoV-2 infection. Br J Haematol. 2020;190(5):e274-e276.
44. Hashemieh M. Preventive Strategies for Cancer Patients during COVID-19 Pandemic: A Review. Int J Pediatr. 2021;9(2):12981-12987.
45. Ferrari A, Zecca M, Rizzari C, et al. Children with cancer in the time of COVID‐19: An 8‐week report from the six pediatric onco‐hematology centers in Lombardia, Italy. Pediatr Blood Cancer. 2020;67(8):e28410.
46. André N, Rouger‐Gaudichon J, Brethon B, et al. COVID‐19 in pediatric oncology from French pediatric oncology and hematology centers: High risk of severe forms? Pediatr Blood Cancer. 2020;67(7):e28392.
47. Dorantes-Acosta E, Avila-Montiel D, Klünder-Klünder M, et al. Survival and complications in pediatric patients with cancer and COVID-19: a meta-analysis. Front Oncol. 2021;10:608282.
48. Mukkada S, Bhakta N, Chantada GL, et al. Global characteristics and outcomes of SARS-CoV-2 infection in children and adolescents with cancer (GRCCC): a cohort study. Lancet Oncol. 2021;22(10):1416-1426.
49. Faranoush P, Jahandideh A, Nekouian R, et al. Evaluation of the in vitro and in vivo effect of liposomal doxorubicin along with oncolytic Newcastle disease virus on 4T1 cell line: Animal preclinical research. Vet Med Sci. 2023;9(3):1426-1437.
| Files | ||
| Issue | Vol 18 No 4 (2024) | |
| Section | Original Article(s) | |
| Keywords | ||
| Covid-19; Cancer; Pediatric oncology | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Arian Y, Faranoush P, Ehsanipour F, Sadighnia N, Elahinia A, Faranoush M. Clinical Outcomes of Pediatric Cancer Patients with COVID-19: A Cross-Sectional Study. Int J Hematol Oncol Stem Cell Res. 2024;18(4):314-323.
