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Delayed diagnosis and treatment of children with cancer during the COVID-19 pandemic
  • +11
  • Michal Dvori,
  • Assaf Barg,
  • Sarah Elitzur,
  • Shlomit Barzilai-Birenboim,
  • Gil Gilad,
  • Shirah Amar,
  • Helen Toledano,
  • Amos Toren,
  • Sigal Weinreb,
  • Gal Goldstein,
  • Adi Shapira-Lewinson,
  • shifra ash,
  • Shai Izraeli,
  • Oded Gilad
Michal Dvori
Schneider Children's Medical Center of Israel

Corresponding Author:[email protected]

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Assaf Barg
Chaim-Sheba Medical Center
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Sarah Elitzur
Schneider Children's Medical Center of Israel
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Shlomit Barzilai-Birenboim
Schneider Children's Medical Center of Israel
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Gil Gilad
Schneider Children's Medical Center of Israel Rina Zaizov Pediatric Hematology Oncology Division
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Shirah Amar
Schneider Children's Medical Center of Israel
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Helen Toledano
Schneider Children's Medical Center of Israel
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Amos Toren
Sheba Medical Center at Tel Hashomer
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Sigal Weinreb
Hadassah Hebrew University Medical Center,
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Gal Goldstein
Hadassah Hebrew University Medical Center,
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Adi Shapira-Lewinson
The Ruth Rappaport Children’s Hospital
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shifra ash
The Ruth Rappaport Children’s Hospital
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Shai Izraeli
Schneider Children's Medical Center of Israel
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Oded Gilad
Schneider Children's Medical Center of Israel
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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.
Aug 2021Published in International Journal of Clinical Oncology volume 26 issue 8 on pages 1569-1574. 10.1007/s10147-021-01971-3