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SARS-CoV-2 in children with cancer or after haematopoietic stem cell transplant: An analysis of 131 patients.
Haeusler, Gabrielle M; Ammann, Roland A; Carlesse, Fabianne; Groll, Andreas H; Averbuch, Dina; Castagnola, Elio; Agyeman, Philipp K A; Phillips, Bob; Gilli, Flávio; Solopova, Galina; Attarbaschi, Andishe; Wegehaupt, Oliver; Speckmann, Carsten; Sung, Lillian; Lehrnbecher, Thomas.
  • Haeusler GM; Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; NHMRC National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia; The Paediatric Integrated Cancer Service, Parkville,
  • Ammann RA; Paediatric Hematology and Oncology, Department of Paediatrics, Inselspital, Bern University Hospital, Bern, Switzerland; Kinderaerzte KurWerk, Burgdorf, Switzerland.
  • Carlesse F; Paediatric Oncology Institute, GRAACC/Federal University of Sao Paulo, Sao Paulo, Brazil.
  • Groll AH; Infectious Disease Research Program, Center for Bone Marrow Transplantation, Department of Paediatric Hematology and Oncology, University Children's Hospital Münster, Münster, Germany.
  • Averbuch D; Paediatric Infectious Disease, Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel.
  • Castagnola E; Infectious Diseases Unit, Department of Paediatrics, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
  • Agyeman PKA; Paediatric Hematology and Oncology, Department of Paediatrics, Inselspital, Bern University Hospital, Bern, Switzerland.
  • Phillips B; Leeds Cancer Centre, Leeds Teaching Hospital, NHS Trust, Leeds, United Kingdom; Centre for Reviews and Dissemination, University of York, York, United Kingdom.
  • Gilli F; Department of Paediatric Intensive Care, Centro Infantil Boldrini, Campinas, Brazil.
  • Solopova G; Dmitry Rogachev Federal Scientific-Clinical Center of Children's Hematology, Oncology and Immunology, Moscow, Russia.
  • Attarbaschi A; Paediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria.
  • Wegehaupt O; Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Paediatrics and Adolescent Medicine, Department of Paediatric Hematology and Oncology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Speckmann C; Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Paediatrics and Adolescent Medicine, Department of Paediatric Hematology and Oncology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Sung L; Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Lehrnbecher T; Paediatric Hematology and Oncology, Hospital for Children and Adolescents, Johann Wolfgang Goethe University, Frankfurt, Germany.
Eur J Cancer ; 159: 78-86, 2021 12.
Article in English | MEDLINE | ID: covidwho-1719646
ABSTRACT

PURPOSE:

There are limited data on SARS-CoV-2 (COVID-19) infection in children with cancer or after haematopoietic stem cell transplant (HSCT). We describe the severity and outcomes of SARS-COV-2 in these patients and identify factors associated with severe disease.

METHODS:

This was a multinational, observational study of children (aged <19 years) with cancer or HSCT and SARS-CoV-2 confirmed by polymerase chain reaction. COVID-19 was classified as asymptomatic, mild, moderate, severe or critical (≥1 organ support). Exact polytomous regression was used to determine the relationship between clinical variables and disease severity.

RESULTS:

One hundred and thirty-one patients with COVID-19 across 10 countries were identified (median age 8 years). Seventy-eight (60%) had leukaemia/lymphoma, 48 (37%) had solid tumour and five had primary immunodeficiency and HSCT. Fever (71%), cough (47%) and coryza (29%) were the most frequent symptoms. The median duration of detectable virus was 16 days (range, 1-79 days). Forty-nine patients (37%) were hospitalised for COVID-19 symptoms, and 15 (11%) required intensive care unit-level care. Chemotherapy was delayed/modified in 35% of patients. COVID-19 was asymptomatic in 32% of patients, mild in 47%, moderate in 8%, severe in 4% and critical in 9%. In 124 patients (95%), a full recovery was documented, and four (3%) died due to COVID-19. Any comorbidity (odds ratio, 2.94; 95% confidence interval [CI], 1.81-5.21), any coinfection (1.74; 95% CI 1.03-3.03) and severe baseline neutropenia (1.82; 95% CI 1.13-3.09) were independently and significantly associated with increasing disease severity.

CONCLUSION:

Although most children with cancer had asymptomatic/mild disease, 13% had severe COVID-19 and 3% died. Comorbidity, coinfection and neutropenia may increase the risk of severe disease. Our data may help management decisions in this vulnerable population.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hematopoietic Stem Cell Transplantation / COVID-19 / Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study Limits: Adolescent / Child / Child, preschool / Female / Humans / Male Language: English Journal: Eur J Cancer Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hematopoietic Stem Cell Transplantation / COVID-19 / Neoplasms Type of study: Diagnostic study / Observational study / Prognostic study Limits: Adolescent / Child / Child, preschool / Female / Humans / Male Language: English Journal: Eur J Cancer Year: 2021 Document Type: Article