Delayed diagnosis and treatment of children with cancer during the
COVID-19 pandemic
Abstract
Background: COVID-19, the novel coronavirus has caused a global pandemic
affecting millions of people around the world. Although children,
including children with cancer, have been found to be affected less
commonly and less severely than adults, indirect effects of the pandemic
on the diagnosis and treatment of children with cancer have been less
described. Methods: A survey was performed in the four largest tertiary
pediatric hematology-oncology medical centers in Israel. Clinical and
laboratory data were collected from the medical files of patients
diagnosed or treated with cancer during April-October 2020. Results:
Seventeen patients are described, who had significant delay in diagnosis
or treatment of cancer. These represent approximately 10% of all the
pediatric cancer diagnosed during the study period in these centers. A
main cause of delay was fear of exposure to COVID-19 (fears felt by the
patient, parent, physician, or decision-makers at the institution; or
the implementation of national guidelines). Delays also resulted from
co-infection with COVID-19 and the attribution of the oncologic symptoms
to the infection. In addition, treatment was delayed of patients already
diagnosed with cancer, due to COVID-19 infection detected in the
patient, a family member, or a bone marrow donor. Conclusion: Fear from
the COVID-19 pandemic may result in delayed diagnosis and treatment of
children with cancer, which may carry a risk to dismal prognosis. It is
crucial that pediatricians and patients alike remember that other
diseases still prevail and must be thought of and treated in a timely
fashion.