The Unique Balancing Act of Managing Children With Cancer and COVID-19 Infection: A Single Center Experience From South India

J Pediatr Hematol Oncol. 2022 Jan 1;44(1):e287-e292. doi: 10.1097/MPH.0000000000002148.

Abstract

Children with cancer are vulnerable to severe infections. Balancing the intensive treatment of cancer, with the potential risk of coronavirus disease-2019 (COVID-19) related morbidity and mortality is a unique challenge. Children with cancer testing positive for severe acute respiratory syndrome coronavirus 2 virus by reverse-transcription polymerase chain reaction at our center were studied. Thirty-seven children tested positive for COVID-19 during the study period. The severity of the illness was mild, moderate, severe, and critical in 10 (27%), 13 (35%), 12 (32%), and 2 (5%) patients, respectively. Of the 14 patients with a severe/critical illness, 2 had oncological emergencies, 4 had dengue co-infection, and 1 had an inguinal bacterial abscess. All patients were discharged in a stable condition. Modification of the treatment protocol was performed in 11 (33%) of 33 patients who were on active treatment for cancer. There was a median delay of 32.5 days to administer the next cycle of chemotherapy in patients who acquired COVID-19 during cancer treatment. Six of 7 patients who were retested after 14 days remained positive by reverse-transcription polymerase chain reaction. Children with cancer with COVID-19 recover with good supportive care. Curative chemotherapy can be administered safely with appropriate modifications in children with cancer with COVID-19.

MeSH terms

  • Adolescent
  • Antineoplastic Agents / therapeutic use
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • COVID-19 / therapy
  • Child
  • Child, Preschool
  • Disease Management
  • Female
  • Humans
  • India / epidemiology
  • Infant
  • Infant, Newborn
  • Male
  • Neoplasms / complications*
  • Neoplasms / epidemiology
  • Neoplasms / therapy
  • Retrospective Studies
  • SARS-CoV-2 / isolation & purification

Substances

  • Antineoplastic Agents