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Pediatric cancer patients not at greater risk of COVID-19 morbidity

Article

COVID-19 can lead to severe illness in patients with underlying health conditions. A research letter indicates that children who have pediatric cancer may not be at risk of more serious disease.

COVID-19 has been shown to be particularly dangerous for people with underlying health conditions. A research letter in JAMA Oncology indicates that cancer in children does not increase risk of infection or morbidity.1

Investigators at the Memorial Sloan Kettering Cancer Center (MSK), New York, instituted a screening and testing plan in mid-March 2020 in the MSK Kids pediatric program. The testing was carried out in 3 cohorts: patients who had been exposed to COVID-19 or who had symptoms of infection; asymptomatic patients prior to deep sedation, admission to the hospital, or myelosuppressive chemotherapy; and caregivers who were accompanying patients.

A total of 335 tests were performed on patients and caregivers between March 10, 2020 and April 12, 2020. Among the 178 unique pediatric patients, 20 returned positive test results. In patients who were tested for positive screening or symptoms, the rate of positive for SARS-CoV-2 was 29.3%. In the 120 asymptomatic patients without known exposure, the rate of SARS-CoV-2 positivity was 2.5%. Only 1 patient required noncritical care hospitalization for COVID-19. Three patients without significant COVID-19 symptoms were admitted for planned chemotherapy, concomitant fever and neutropenia, or cancer morbidity. The other patients were managed at home.

The researchers noted that their research was limited by small numbers, but the findings do suggest that children with cancer aren’t more vulnerable to infection or morbidity from SARS-CoV-2 than other children.

References:

1.    Boulad F, Kamboj M, Bouvier N, Mauguen A, Kung AL. COVID-19 in children with cancer in New York City. JAMA Oncol. May 13, 2020. Epub ahead of print. doi: 10.1001/jamaoncol.2020.2028

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Tina Tan, MD, FAAP, FIDSA, FPIDS, editor in chief, Contemporary Pediatrics, professor of pediatrics, Feinberg School of Medicine, Northwestern University, pediatric infectious diseases attending, Ann & Robert H. Lurie Children's Hospital of Chicago
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