Almost one-fifth of children with cancer and COVID-19 have severe and critical illness and 3.8 percent die, according to a study published online Aug. 26 in The Lancet Oncology.
Sheena Mukkada, M.D., from St. Jude Children’s Research Hospital in Memphis, Tennessee, and colleagues conducted a cohort study with data from 131 institutions in 45 countries to create a Global Registry of COVID-19 in Childhood Cancer for children and adolescents (<19 years).
The researchers found that 19.9 percent of 1,301 patients had a severe or critical infection and 3.8 percent of 1,319 died with the cause attributed to COVID-19. Overall, 55.8 percent of 1,092 patients receiving active oncologic treatment had modifications to cancer-directed therapy. Factors associated with severe or critical illness included World Bank low-income or lower-middle-income and upper-middle-income country status (odds ratios, 5.8 and 1.6, respectively), age 15 to 18 years, absolute lymphocyte count of 300 or less cells per mm3, absolute neutrophil count of 500 or less cells per mm3, and intensive treatment (odds ratios, 1.6, 2.5, 1.8, and 1.8, respectively). Upper-middle-income country status, a primary diagnosis of hematologic malignancy, presence of at least one COVID-19 symptom, and presence of one or more comorbidities were associated with treatment modification (odds ratios, 0.5, 0.5, 1.8, and 1.6, respectively).
“The results are reassuring that many children can continue their cancer treatment safely, but they also highlight important clinical features that may predict a more severe clinical course and the need for greater vigilance for some patients,” a coauthor said in a statement.
One author disclosed financial ties to the pharmaceutical industry.
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