COVID-19 infections in pediatric hematology oncology patients in Louisiana

ABSTRACT

Purpose of Study The majority of documented SARS-CoV2 infections in children have been mild illnesses. The highest frequency of infection is documented in children between the ages of 5 -17 years;with the incidence of SARS-CoV2 being the highest in adolescents aged 12-17 years. Severe respiratory complications and a multi-system inflammatory syndrome (MIS-C) have been documented in pediatrics. There is very limited information about pediatric hematology and oncology patients in the United States, actively undergoing therapy, and how SARS-CoV2 affects them. Louisiana was an early 'hotspot' for SARS-CoV2 with its first documented infection on March 9, 2020. We present our institutional experience with SARS-CoV2 and pediatric hematology-oncology patients. Methods Used A retrospective chart review was performed on all pediatric hematology-oncology patients who were actively being treated at Children's Hospital of New Orleans between March 9, 2020, through December 15, 2020. Any patient who had a positive SARS-CoV2 test was included in the chart review. Information including demographics, signs, and symptoms at the time of testing, hospitalization, medications, diagnosis, and treatment was obtained. The institutional review board at Louisiana State University Health Sciences Center and Children's Hospital of New Orleans approved this study. Summary of Results Between March 9, 2020 and December 15, 2020, 15,404 patients were tested for SARS-CoV2 at Children's Hospital of New Orleans;628 children tested positive. Ten of those children had a pediatric hematological or oncological diagnosis. The mean age of the pediatric hematology- oncology patients was 7.9 years, and 80% were female. Ten percent of the patients identified as Hispanic. Forty percent were African American. Of the 10, four children (40%) had a diagnosis of acute lymphoblastic leukemia, and all were actively undergoing chemotherapy. One of the ten total children had undergone a bone marrow transplant. Five (50%) were hospitalized;2 (20%) with severe infections requiring PICU admission and 3 (30%) patients were treated for MIS-C with SARS-CoV2 specific therapy including Remdesivir, steroids, and Tocilizumab. One of our patients died from SARSCoV2 related complications. Conclusions Pediatric hematology-oncology patients are a heterogeneous group of patients, and little was known about how SARS-CoV2 would affect these patients. Of the 15,404 patients tested for SARS-CoV2 at CHNOLA, there were 628 that tested positive between March 9, 2020, and December 15, 2020. 1.6% of those had an oncology or hematology diagnosis. Most of our pediatric hematology oncology patients did not require hospitalization and did not require treatment. There was one patient who died of SARS-CoV2 related complications.