COVID-19 Outcomes in Children, Adolescents and Young Adults with Cancer
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
Résumé en anglais
Pediatric oncology patients are at risk for poor outcomes with respiratory viral infections. Outcome data for COVID-19 in children and young adults with cancer are needed; data are sparse for obese/overweight and adolescent and young adult subgroups. We conducted a single center cohort study of COVID-19 outcomes in patients younger than 25 years with cancer. Candidate hospitalization risk factors were analyzed via univariable and multivariable analyses. 87 patients with cancer and COVID-19 were identified. Most were Hispanic/Latinx (n=63, 72%). 42 (48%) were overweight/obese. Anti-cancer therapy included chemotherapy only (n=64, 74%), chimeric antigen receptor T-cells (CAR-T, n=7), hematopoietic stem cell transplantation (HSCT, n=12), or CAR-T and HSCT (n=4). There was no COVID-19 related mortality. 26 patients (30%) required COVID-19 related hospitalization; 4 required multiple hospitalizations. 9 (10%) had severe/critical infection; 6 needed intensive care. COVID-19 resulted in anti-cancer therapy delays in 22 (34%) of 64 patients on active therapy (median delay=14 days). Factors associated with hospitalization included steroids within 2 weeks prior to infection, lymphopenia, previous significant non-COVID infection, and low COVID-19 PCR cycle threshold value. CAR-T recipients with B-cell aplasia tended to have severe/critical infection (3 of 7 patients). A COVID-19 antibody response was detected in 14 of 32 patients (44%). A substantial proportion of COVID-19 infected children and young adults with cancer require inpatient management; morbidity may be high in B-cell immunodeficiency. However, a majority of patients can be taken through chemotherapy without prolonged therapy delays. Viral load is a potential outcome predictor in COVID-19 in pediatric cancer. This article is protected by copyright. All rights reserved.
