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Flash survey on severe acute respiratory syndrome coronavirus-2 infections in paediatric patients on anticancer treatment

Hrusak O 1 , Kalina T 2 , Wolf J 3 , Balduzzi A 4 , Provenzi M 5 , Rizzari C 6 Show all authors , Rives S 7 , Del Pozo Carlavilla M 8 , Alonso MEV 8 , Domínguez-Pinilla N 9 , Bourquin JP 10 , Schmiegelow K 11 , Attarbaschi A 12 , Grillner P 13 , Mellgren K 14 , van der Werff Ten Bosch J 15 , Pieters R 16 , Brozou T 17 , Borkhardt A 17 , Escherich G 18 , Lauten M 19 , Stanulla M 20 , Smith O 21 , Yeoh AEJ 22 , Elitzur S 23 , Vora A 24 , Li CK 25 , Ariffin H 26 , Kolenova A 27 , Dallapozza L 28 , Farah R 29 , Lazic J 30 , Manabe A 31 , Styczynski J 32 , Kovacs G 33 , Ottoffy G 34 , Felice MS 35 , Buldini B 36 , Conter V 4 , Stary J 37 , Schrappe M 38

Affiliations 

  • 1 CLIP - Childhood Leukaemia Investigation Prague, Czech Republic; Department of Pediatric Hematology, Charles University and Univ. Hospital Motol, Prague, Czech Republic. Electronic address: Ondrej.Hrusak@lfmotol.cuni.cz
  • 2 CLIP - Childhood Leukaemia Investigation Prague, Czech Republic; Department of Pediatric Hematology, Charles University and Univ. Hospital Motol, Prague, Czech Republic
  • 3 Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
  • 4 Clinica Pediatrica Universita degli Studi di Milano Bicocca, Monza, Italy
  • 5 Oncologia Pediatrica, Ospedale Papa Giovanni XXIII, Bergamo, Italy
  • 6 Pediatric Hematology Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, MBBM Foundation, ASST Monza, Italy
  • 7 Hospital Sant Joan de Déu de Barcelona, Spain
  • 8 Hospital General Universitario de Albacete, Spain
  • 9 Hospital Virgen de la Salud, Spain
  • 10 Department of Oncology and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
  • 11 Department of Peadiatrics and Adolescent Medicine, Rigshospitalet University Hospital, Copenhagen, Denmark
  • 12 Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
  • 13 Pediatric Oncology, Karolinska University Hospital, Sweden
  • 14 Department of Pediatric Haematology and Oncology, Sahlgrenska University Hospital, Gothenberg, Sweden
  • 15 UZ Brussels, Belgium
  • 16 Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
  • 17 Department of Pediatric Oncology Hematology and Clinical Immunology Heinrich Heine University Dusseldorf
  • 18 Klinik für Pädiatrische Hämatologie und Onkologie Universtitätsklinikum Eppendorf, Hamburg, Germany
  • 19 University Hospital Schleswig-Holstein, Campus Lübeck, Germany
  • 20 Department of Pediatric Haematology and Oncology, Hannover Medical School, Hannover, Germany
  • 21 National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
  • 22 Yong Loo Lin School of Medicine and Cancer Science Institute, National University of Singapore, and Viva-University Children's Cancer Centre, National University Hospital, Singapore
  • 23 Schneider Children's Medical Center of Israel
  • 24 Great Ormond Street Hospital, London, UK
  • 25 Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
  • 26 University of Malaya Medical Centre, Kuala Lumpur, Malaysia
  • 27 Department of Pediatric Hematology and Oncology, Comenius University, Bratislava, Slovakia
  • 28 The Cancer Centre for Children, The Children's Hospital at Westmead, Australia
  • 29 LAUMC-Rizk Hospital, Beirut, Lebanon
  • 30 University Children`s Hospital, Belgrade, Serbia
  • 31 Hokkaido University in Hospital, Sapporo, Japan
  • 32 Department of Pediatric Hematology and Oncology, Nicolaus Copernicus University, Bydgoszcz, Poland
  • 33 2nd Department of Paediatrics, Semmelweis University, Budapest, Hungary
  • 34 Oncohematology Unit, Dep. of Ped., University of Pécs, Hungary
  • 35 Hospital de Pediatría, "Prof. Dr. Juan P. Garrahan", Argentina
  • 36 Onco Hematology Unit, Dept. Salute della Donna e del Bambino, Università degli Studi di Padova, Italy
  • 37 Department of Pediatric Hematology, Charles University and Univ. Hospital Motol, Prague, Czech Republic
  • 38 Childrens Hospital Medical Center Schleswig-Holstein, Kiel, Germany
Eur J Cancer, 2020 Jun;132:11-16.
PMID: 32305831 DOI: 10.1016/j.ejca.2020.03.021

Abstract

INTRODUCTION: Since the beginning of COVID-19 pandemic, it is known that the severe course of the disease occurs mostly among the elderly, whereas it is rare among children and young adults. Comorbidities, in particular, diabetes and hypertension, clearly associated with age, besides obesity and smoke, are strongly associated with the need for intensive treatment and a dismal outcome. A weaker immunity of the elderly has been proposed as a possible explanation of this uneven age distribution. Thus, there is concern that children treated for cancer may allso be at risk for an unfavourable course of infection. Along the same line, anecdotal information from Wuhan, China, mentioned a severe course of COVID-19 in a child treated for leukaemia.

AIM AND METHODS: We made a flash survey on COVID-19 incidence and severity among children on anticancer treatment. Respondents were asked by email to fill in a short Web-based survey.

RESULTS: We received reports from 25 countries, where approximately 10,000 patients at risk are followed up. At the time of the survey, more than 200 of these children were tested, nine of whom were positive for COVID-19. Eight of the nine cases had asymptomatic to mild disease, and one was just diagnosed with COVID-19. We also discuss preventive measures that are in place or should be taken and treatment options in immunocompromised children with COVID-19.

CONCLUSION: Thus, even children receiving anticancer chemotherapy may have a mild or asymptomatic course of COVID-19. While we should not underestimate the risk of developing a more severe course of COVID-19 than that observed here, the intensity of preventive measures should not cause delays or obstructions in oncological treatment.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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