Clinical Characteristics and Outcome of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italian Pediatric Oncology Patients: A Study From the Infectious Diseases Working Group of the Associazione Italiana di Oncologia e Ematologia Pediatrica.


Journal

Journal of the Pediatric Infectious Diseases Society
ISSN: 2048-7207
Titre abrégé: J Pediatric Infect Dis Soc
Pays: England
ID NLM: 101586049

Informations de publication

Date de publication:
10 Nov 2020
Historique:
received: 10 06 2020
accepted: 09 07 2020
pubmed: 12 7 2020
medline: 18 11 2020
entrez: 12 7 2020
Statut: ppublish

Résumé

Little is known as yet about the outcome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children being treated for cancer. We collected information on the clinical characteristics and outcomes of a cohort of 29 children (16 female and 13 male; median age, 7 years [range, 0-16 years]) diagnosed with SARS-CoV-2 infection while on chemotherapy/immunotherapy (n = 26), or after stem cell transplantation (n = 3) during the peak of the epidemic in Italy. These patients suffered from leukemia (n = 16), lymphoma (n = 3), solid tumors (n = 10), and Langerhans cell histiocytosis (n = 1). The course of the disease was mild in all cases, with only 12 children developing symptoms (pneumonia in 3 cases), and none needing intensive care. Fifteen patients were hospitalized, including 7 asymptomatic patients. Nine patients (including 5 with no symptoms) were given hydroxychloroquine, and 3 of them were also given lopinavir/ritonavir. Among the 26 patients on chemotherapy/immunotherapy, the treatment was suspended in 16 cases for a median of 26 days (range, 15-68 days), whereas 8 patients continued their chemotherapy and 2 had minor modifications to their treatment regimen. SARS-CoV-2 infection seems to take a milder clinical course in children than in adults with cancer. Specific SARS-CoV-2 treatment seems unnecessary for most children. In light of our findings, and albeit with the necessary caution, we suggest avoiding major changes to planned anticancer treatments in pediatric patients acquiring COVID-19.

Sections du résumé

BACKGROUND BACKGROUND
Little is known as yet about the outcome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children being treated for cancer.
METHODS METHODS
We collected information on the clinical characteristics and outcomes of a cohort of 29 children (16 female and 13 male; median age, 7 years [range, 0-16 years]) diagnosed with SARS-CoV-2 infection while on chemotherapy/immunotherapy (n = 26), or after stem cell transplantation (n = 3) during the peak of the epidemic in Italy. These patients suffered from leukemia (n = 16), lymphoma (n = 3), solid tumors (n = 10), and Langerhans cell histiocytosis (n = 1).
RESULTS RESULTS
The course of the disease was mild in all cases, with only 12 children developing symptoms (pneumonia in 3 cases), and none needing intensive care. Fifteen patients were hospitalized, including 7 asymptomatic patients. Nine patients (including 5 with no symptoms) were given hydroxychloroquine, and 3 of them were also given lopinavir/ritonavir. Among the 26 patients on chemotherapy/immunotherapy, the treatment was suspended in 16 cases for a median of 26 days (range, 15-68 days), whereas 8 patients continued their chemotherapy and 2 had minor modifications to their treatment regimen.
CONCLUSIONS CONCLUSIONS
SARS-CoV-2 infection seems to take a milder clinical course in children than in adults with cancer. Specific SARS-CoV-2 treatment seems unnecessary for most children. In light of our findings, and albeit with the necessary caution, we suggest avoiding major changes to planned anticancer treatments in pediatric patients acquiring COVID-19.

Identifiants

pubmed: 32652521
pii: 5870367
doi: 10.1093/jpids/piaa088
pmc: PMC7454778
doi:

Substances chimiques

Antineoplastic Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

530-534

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Auteurs

Gianni Bisogno (G)

Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padova, Italy.

Massimo Provenzi (M)

Pediatric Hematology/Oncology Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy.

Daniele Zama (D)

Department of Pediatrics, Pediatric Oncology and Hematology Unit "Lalla Seràgnoli," Sant' Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.

Annalisa Tondo (A)

Department of Pediatric Hematology-Oncology, A. Meyer University Children's Hospital, Florence, Italy.

Cristina Meazza (C)

Pediatric Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy.

Antonella Colombini (A)

Department of Pediatrics, Ospedale San Gerardo, University of Milano-Bicocca, Fondazione Monza e Brianza per il Bambino e la sua Mamma, Monza, Italy.

Federica Galaverna (F)

Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children's Hospital, Rome, Italy.

Francesca Compagno (F)

Pediatric Hematology/Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy.

Francesca Carraro (F)

Stem Cell Transplantation and Cellular Therapy Division, Pediatric Onco-Hematology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Regina Margherita Childrens Hospital, Turin, Italy.

Raffaela De Santis (R)

Pediatric Hematology Oncology, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy.

Linda Meneghello (L)

Department of Pediatrics, Santa Chiara Hospital, Trento, Italy.

Valentina Baretta (V)

Pediatric Hematology/Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.

Simone Cesaro (S)

Pediatric Hematology/Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.

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