Results
A total of 888 pediatric oncology patients were identified to have SARS-CoV-2 infection by RT-PCR testing and were registered in the ROHA between April 12, 2020 (EW 16) and March 5, 2022 (EW 9).
In Argentina, there have been three important COVID-19 waves since the beginning of the pandemic; the first in EW 40 of 2020 with 21 cases/week, the second in EW 23 of 2021 with 18 cases/week, and the third and largest in EW 3 of 2022 with 68 cases/week (Fig. 2).
Median age of the patients at COVID-19 diagnosis was 7 years (range, 3 months to 19 years); 55% were male. Most of the confirmed cases (31%) were patients between 5 and 9 years old (n=275), followed by patients between 1 and 4 years old (29%; n=260). Twenty-three patients under 1 year of age were reported, of whom 12 had retinoblastoma, seven leukemia, two hepatoblastoma, one neuroblastoma, and one glioma.
The majority of SARS-CoV-2-positive children with cancer had leukemia (n=437), followed by central nervous system tumor (n=120), which accounted for 63% of the total number of patients.
At diagnosis, 42% (n=371) of the patients were asymptomatic. Of those symptomatic patients (n=508), 75% had fever (n=381) lasting less than 3 days in 74% of the cases. Table 1 shows the symptoms observed according to frequency. Considering the WHO classification, the majority of the cases were mild (n=333; 37.5%). Of 210 patients with neutropenia (less than 1000 neutrophils), 59% had fever (n=124).
Seventeen percent of the patients were diagnosed with COVID-19 within the first month at cancer diagnosis. Very few patients (2.5%) received specific treatment for the disease (Table 1).
A total of 112 cancer patients with a history of SARS-CoV-2 infection died, 51% of whom had leukemia/lymphoma. The most frequent cause of death was disease progression (61%) and in only seven (6%) children COVID-19 was the cause of death (Table 2).
Of the total number of patients with leukemia or lymphoma (n=526), one patient died of COVID-19 in the first wave (0.6%), four in the second (2.2%), and two in the third (1.1%). In statistical analysis the comparison of these rates yielded a value of 1.87 (p 0.39) (Fig. 2 and Table 3).