Impact of COVID-19 in pediatric oncology care in Latin America during
the first year of the pandemic
Abstract
The ongoing COVID-19 pandemic strained medical systems worldwide. We
report on the impact on pediatric oncology care in Latin American
(LATAM) during its first year. Four cross-sectional surveys were
electronically distributed among pediatric onco-hematologist in
April/June/October 2020, and April/2021 through the Latin American
Society of Pediatric Oncology (SLAOP) email list and St Jude Global
regional partners. 453 pediatric onco-hematologists from 20 countries
responded the first survey with subsequent surveys response rates above
85%. More than 95% of participants reported that treatment continued
without interruption for new and active on-going patients, though with
disruptions in treatment availability. During the first three surveys,
respondents reported suspensions of outpatient procedures (54.2%), a
decrease in oncologic surgeries (43.6%), radiotherapy (28.4%), stem
cell transplants (SCT) (69.3%), and surveillance consultations
(81.2%). Logistic regression analysis showed that at the beginning of
the first wave, participants from countries with healthcare expenditure
below 7% were more likely to report a decrease in outpatient procedures
(OR:1.84, 95%C:1.19;2.8), surgeries (OR:3, 95%CI:1.9;4.6) and
radiotherapy (OR:6, 95%CI:3.5;10.4). Suspension of surveillance
consultations was higher in countries with COVID-19 case fatality rates
above 2% (OR:3, 95%CI:1.4;6.2) and SCT suspensions in countries with
COVID-19 incidence rate above 100 cases per 100,000 (OR:3.48,
95%CI:1.6;7.45). Paradoxically, at the beginning of the second wave
with COVID-19 cases rising exponentially, most participants reported
improvements in cancer services availability. Our data show the
medium-term collateral effects of the pandemic on pediatric oncology
care in LATAM, which might help delineate oncology care delivery amid
current and future challenges posed by the pandemic.