Abstract
Background: Coronavirus disease-2019 (COVID-19) could be associated with
morbidity and mortality in immunocompromised children. Objective: To
measure the frequency of SARS-COV-2 infection among hospitalized
children with cancer and detect the associated clinical manifestations
and outcomes. Methodology: A prospective non-interventional study
including all hospitalized children with cancer conducted between
mid-April and mid-June 2020 in Ain Shams University hospital, Egypt.
Clinical, laboratory and radiological data were collected. SARS-CoV2
infection was diagnosed by RT-PCR tests in nasopharyngeal swabs.
Results: Fifteen of 61 hospitalized children with cancer were diagnosed
with SARS-COV-2. Their mean age was 8.3±3.5 years. Initially, 10(66.7%)
were asymptomatic and 5(33.3%) were symptomatic with fever and/or
cough. Baseline laboratory tests other than SARS-COV-2 RT-PCR were not
diagnostic; the mean absolute lymphocyte count was 8.7±2.4 x109/L,
C-reactive protein was mildly elevated in most of patients. Imaging was
performed in 10(66.7%) patients with significant radiological findings
detected in 4(40%) patients. Treatment was mainly supportive with
antibiotics as per the febrile neutropenia protocol and local Children
Hospital guidance for management of COVID-19 in children. Conclusion:
Pediatric cancer patients with COVID-19 were mainly asymptomatic or with
mild symptoms. A high index of suspicion and regular screening with
nasopharyngeal swab in asymptomatic hospitalized cancer patients is
recommended.