Covid-19 Pandemic and Childhood Cancer: Lessons Learnt from a Pediatric Oncology Unit in a Developing Country

Manasa Kakunje; Niteesh Bharadwaj; Kenson Sam Alex; Vandana Bharadwaj; Anand Prakash

doi:10.31557/apjcc.2023.8.1.213-218

Authors

Manasa Kakunje Division of Pediatric Hematology Oncology and Stem Cell Transplantation, Department of Pediatrics, St John’s Medical College Hospital, Bengaluru, Karnataka, India.
Niteesh Bharadwaj Division of Pediatric Hematology Oncology and Stem Cell Transplantation, Department of Pediatrics, St John’s Medical College Hospital, Bengaluru, Karnataka, India.
Kenson Sam Alex Division of Pediatric Hematology Oncology and Stem Cell Transplantation, Department of Pediatrics, St John’s Medical College Hospital, Bengaluru, Karnataka, India.
Vandana Bharadwaj Division of Pediatric Hematology Oncology and Stem Cell Transplantation, Department of Pediatrics, St John’s Medical College Hospital, Bengaluru, Karnataka, India.
Anand Prakash Division of Pediatric Hematology Oncology and Stem Cell Transplantation, Department of Pediatrics, St John’s Medical College Hospital, Bengaluru, Karnataka, India.

DOI:

https://doi.org/10.31557/apjcc.2023.8.1.213-218

Keywords:

Pandemic, Chemotherapy, Children

Abstract

Background: COVID-19 pandemic has caused unprecedented challenges to healthcare delivery globally. Children with cancer are a vulnerable group given their immunosuppressed state. There is paucity of data regarding the organisation of pediatric cancer care and outcomes of children with cancer who developed COVID-19 infection. We describe the organisation of care in a Pediatric Oncology unit in a tertiary care hospital in South India and describe the clinical profile and outcomes of children with cancer who were diagnosed with COVID-19 infection.
Methods: This was a retrospective chart review of all children admitted to the pediatric oncology unit and diagnosed with COVID-19 infection between March 2020 and October 2020. Descriptive statistics were calculated.
Results: A total of 144 children were on active chemotherapy during the study period. Of these, Nine (6.2 %) were diagnosed with COVID-19. Fever and cough were the predominant symptoms. Majority (88%) had mild symptoms. COVID-19 was positive at cancer diagnosis in 22%. PICU care was required for 33%, but for non-covid related concerns. Recovery from Covid-19 was seen in 88%. Chemotherapy administered during or after Covid-19 infection was well tolerated. Co-existent sepsis or CMV infection resulted in severe symptoms leading to mortality and this was not related to severe covid related symptomatology.
Conclusions: In our study, majority of children with cancer who developed covid-19 had mild symptoms and recovered uneventfully. Chemotherapy should not be delayed in children with active cancer. The overall outcomes of pediatric oncology care during the pandemic are reassuring.