SARS COV-2 Infection in Children with Leukemia

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) directed great attention and anxiety all over the world. Epidemiologic models predict that the current COVID-19 pandemic will last several months or even several years, until the development of a vaccine and/or herd immunity. Although the course of the infection is often not severe in children, it can be life threatening especially in immunocompromised children with leukemia. Hematopoietic and lymphoid cancers are accounting for approximately 40% of all childhood cancers. The five-year survival rate for childhood cancer has approached to 70% and more than 80% for leukemia in our country. During COVID pandemic, children with leukemia may also have COVID-19 infection, especially when their bone marrow is depressed due to chemotherapy. It is observed that factors such as the underlying type of cancer, status of remission, or having stem cell transplantation may affect the prognosis. As well as standard and proven treatments for febrile neutropenia, all tests and treatments should be applied very quickly and properly for COVID 19 as is all suspected patients. These efforts may contribute to increase the survival of our children with cancer. Given the absence of data to address concerns related to SARS-CoV-2 infection while on chemotherapy, questions are increasing about the approach for management of systemic immunosuppressive therapies, i.e. ceasing or reducing the immunosuppressive medications in children with leukemia. The current rapid worldwide spread of COVID-19 necessitates identifying optimal preventive strategies and effective medical management. In this report, we tried to review appropriate literature-based approaches for prevention, diagnosis and management of treatment protocols for children with cancer during the pandemic period.