Publication: Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic
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Date
2022-10-01
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Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin\"s lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer.
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Sosyal ve Beşeri Bilimler, Sosyoloji, Social Sciences and Humanities, Sociology, KAMU, ÇEVRE VE İŞ SAĞLIĞI, Sosyal Bilimler Genel, Sosyal Bilimler (SOC), PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, SOCIAL SCIENCES, GENERAL, Social Sciences (SOC), İş Sağlığı ve Terapisi, Güvenlik Araştırması, Sağlık (sosyal bilimler), Genel Sosyal Bilimler, Halk, Çevre ve İş Sağlığı, Epidemiyoloji, Sağlık Bilimleri, Sosyal Bilimler ve Beşeri Bilimler, Occupational Therapy, Safety Research, Health (social science), General Social Sciences, Public Health, Environmental and Occupational Health, Epidemiology, Health Sciences, Social Sciences & Humanities, Paediatrics, Cancer, Health systems, COVID-19, CHILDHOOD-CANCER, PEDIATRIC CANCER, LOW-INCOME, CARE, MORTALITY, SURVIVAL, RISK, ADOLESCENTS, REGISTRIES, IMPACT
Citation
Bandyopadhyay S., Peter N., Lakhoo K., Abib S. d. C. V. , Abdelhafeez H., Wilson S., Pachl M., Martin B., Nagras S., Sheth M., et al., "Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic", BMJ GLOBAL HEALTH, cilt.7, sa.10, 2022