ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) is a global pandemic with no enough data regarding its impact on pediatric cancer patients. Our main aim is to describe the clinical management and outcome of COVID-19 in this vulnerable group. Methods: This prospective study included 76 pediatric oncology patients with confirmed infection in the period between 1st of May and end of November, 2020 with at least two-month follow-up from recruitment. Remdesivir (RDV) was the antiviral therapy used. Findings: The median age of patients was 9 years. Sixty patients were on first line treatment. Haematological malignancies constituted 86.8% of patients. Severe to critical form of infection represent 35.4% of cases. The commonest presentation was fever (93.4%). Chemotherapy was delayed in 59.2% of cases and doses were modified in 30.2%. Most acute lymphoblastic leukemia/lymphoblastic lymphoma (88%) were in maintenance treatment phase while 55% of acute myeloid leukemia were in induction phase. Sixty days overall survival (OS) was 86.6% and mortalities occurred only in critically ill cases. Of the sixteen acute leukemia who were in first induction phase, 13 survived and 10 achieved induction remission. The commonest CT chest finding was ground glass opacities (74.2%). A negative PCR within 2 weeks and improvement of radiological findings were statistically related to disease severity (p=0.008and, 0.002 respectively).Better OS was associated with regression of radiological finding after 30 days from infection (p=0.002). Of the forty-five cases who received RDV, 70% were severe to critically ill cases, yet morality was comparable to NoRDV with no serious adverse events observed. Interpretation: COVID-19 in pediatric cancer patients has good clinical outcome except for critical form of infection at presentation. New oncologic cases tolerate induction therapy with good disease outcome. RDS was well tolerated with no OS difference compared to patients who did not receive the drug.Funding: The present work was funded by the Children’s Cancer Hospital Foundation and Association of Friends of the National Cancer-free Initiative (AFNCI)Declaration of Interest: All authors declare no competing financial interests.Ethical Approval: The approval of hospital ethical committee and family consents were obtained.