Abstract
Objective: To report the experience with COVID-19 in children with cancer at the largest tertiary-cancer care and referral center in India.
Methods: This study is a single tertiary center experience on COVID-19 in children with cancer and continuation of cancer-directed therapy in them. Children ≤ 15 y on active cancer treatment detected with COVID-19 until September 15 th , 2020 were prospectively followed up in the study. Patients were managed in accordance with well-laid guidelines. Treatment was continued for children with COVID-19 who were clinically stable and on intensive treatment for various childhood cancers.
Results: One hundred twenty-two children (median age 8 y; range 1-15 y, male:female 1.7:1) with cancer were diagnosed with COVID-19. Of 118 children, 99 (83.9%), 60 (50.8%), 43 (36.4%), 26 (22.0%), and 6 (5.1%) had RT-PCR positivity at 14, 21, 28, 35, and 60 d from diagnosis of COVID-19, respectively. Scheduled risk-directed intravenous chemotherapy was delivered in 70 (90.9%) of 77 children on active systemic treatment with a median delay of 14 d (range 0-48 d) and no increased toxicities. All-cause mortality rate was 7.4% (n = 9) and COVID-19 related mortality rate was 4.9% (n = 6). One hundred-fifteen (94.2%) children with COVID-19 did not require any form of respiratory support during the course of infection.
Conclusions: COVID-19 was not a major deterrent for the continuation of active cancer treatment despite persistent RT-PCR positivity. The long-term assessment of treatment adaptations requires further prospective follow-up and real-time addressal.
Keywords: COVID-19; Cancer-directed therapy; Children with cancer; Mortality.
【저자키워드】 COVID-19, mortality., Cancer-directed therapy, Children with cancer, 【초록키워드】 Treatment, therapy, children, Cancer, India, Infection, RT-PCR, Chemotherapy, cancers, Follow-up, mortality rate, childhood, Intensive, Care, Respiratory Support, intravenous, systemic treatment, toxicities, median age, active cancer, COVID-19 related mortality, all-cause mortality rate, Course, clinically, median, children with COVID-19, diagnosed with COVID-19, diagnosis of COVID-19, with COVID-19,