INITIAL REPORT ON SPANISH PEDIATRIC ONCOLOGIC, HEMATOLOGIC AND POST STEM
CELL TRANSPLANTATION PATIENTS DURING SARS-COV-2 PANDEMIC
Abstract
Background: Since the beginning of SARS-CoV-2 pandemic, it has been
widely recognized that children and adolescents seem to have milder
clinical courses as compared to adult counterparts. However, there is
concern that vulnerable collectives including pediatric patients treated
for cancer or under immunosuppression may be at higher risk. Methods: We
retrospectively collected Spanish COVID-19 cases in children and
adolescents with solid and hematological malignancies, non-malignant
chronic hematologic conditions, and post allogeneic-stem cell
transplantation, from the beginning of the pandemic on January 31 to
April 24, 2020. Results: We included 47 cases with RT-PCR positive
COVID-19 from 41 centers in Spain, where 97.6% of pediatric patients
are treated for cancer. In most cases (76.6%), infection was
asymptomatic, or symptoms were mild. Severe illness was observed in
14.9% of cases with respiratory distress and/or hypoxemia, and 8.5%
required admission to the PICU. Symptomatic patients received supportive
care associated with antiviral and immunomodulatory agents depending
upon severity. Anticancer therapy was withhold in the majority of cases
during the infection course. Most patients recovered from COVID-19. Two
deaths were reported. Conclusion: In our cohort, most children receiving
anticancer chemotherapy presented a mild clinical course and had a good
outcome. Highly immunosuppressed patients with major comorbidities were
at higher risk of severe infections. Among this fragile collective,
individualized expert discussion is critical for anti-infectious therapy
and appropriate anticancer treatment.