ABSTRACT
Purpose of Study The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has a predilection for severe outcomes in adults. Immunocompromised adults are at higher risk of severe disease. The pediatric population has experienced lower rates of morbidity and mortality. However, recent data shows that pediatric patients with cancer may also be at higher risk of severe disease, as seen in the adult population. This descriptive study will help assess the effect of SARS-CoV-2 infection on pediatric patients with oncologic disorders. Methods Used This IRB-approved retrospective study was conducted between March 2020 to August 2021. Patients between the ages of 0-21 years with an oncologic disorder who tested positive for SARS-CoV-2 were included. Laboratory evaluation was included if within 2 weeks of initial infection with 3 patients being excluded due to no labs available but still included in the clinical analysis. Summary of Results Thirty-one oncology patients with SARSCoV- 2 infection were identified. Median age of 9 years (range 1-20). Fifteen females and 16 males. Diagnoses included were acute leukemia (15), lymphoma (4), CNS tumor (8), and solid tumor (4). Fifty-five percent of patients were asymptomatic and had been tested due to a scheduled hospital admission, procedure requiring sedation, or known exposure to SARSCoV- 2. Forty-eight percent of patients were obese or overweight. Most common symptoms included fever (26%), congestion (19%), and cough (26%). Only 6% of patients complained of loss of taste. No patients complained of loss of smell. Twenty-nine percent of patients had moderate SARS-CoV- 2 disease severity, requiring inpatient management for symptoms without ICU-level care. Three patients developed pneumonia, 2 requiring supplemental oxygen, but none needed ICU-level care. Of the four patients who had completed therapy, one was asymptomatic and the other 3 had mild disease, requiring symptomatic care at home. One patient had been fully vaccinated against SARS-CoV-2 with a mild infection occurring 2 months after the second vaccine. Median laboratory values for patients who had SARSCoV- 2 mild/moderate disease compared to asymptomatic patients included hemoglobin 10.4 g/dL and 11.5 g/dL, platelet 185,000and 198,000, absolute lymphocyte count 820 and 1465, absolute neutrophil count 1145 and 1780, respectively. No statistically significant difference was found. Conclusions Pediatric oncology patients at our institution had a more benign course with SARS-CoV-2 when compared to national and international reports. Although almost half of our patients were obese or overweight, none had severe disease. Loss of taste and/or smell was uncommon in our patients. As data is rapidly growing, it is important to evaluate risk factors, outcomes, and natural history in this vulnerable population in order to develop management guidelines.