Introduction
On March 11th, 2020, the World Health Organization declared the outbreak
of COVID-19, caused by the SARS-CoV-2 virus a pandemic. On April 12th,
2020, the first case in a pediatric patient with cancer in Argentina was
diagnosed. The COVID-19 pandemic has presented a global challenge for
the care of children with
cancer.1
Early reports of the effects of the pandemic on the management of
pediatric cancer patients showed that care was affected worldwide, but
most notably in low- and middle-income
countries.2,3,4These initial reports warned about the possibility of a higher incidence
and more severe COVID-19 disease among cancer patients due to their
immunocompromised status. Nevertheless, subsequent studies showed that
pediatric oncology patients infected with SARS-CoV-2 were not at
increased risk of severe
disease.5,6Indeed, most of the children and adolescents were asymptomatic or the
clinical course was generally mild7–9,
with few
complications10,11and little need for intensive care and mechanical ventilatory
support.7,12
Since the beginning of the pandemic, the management of COVID-19 in
patients in general and cancer patients in particular has gone through
different stages resulting in modifications in the medical behavior.
Children with cancer have always been of particular concern because of
their susceptibility to opportunistic infections due to both disease and
treatment-related immune alterations. Different international studies
have shown that leukemia is one of the most frequent hematology-oncology
diseases associated with SARS-CoV-2
infection.5,7,9,13,14The reported COVID-19-related mortality rate in pediatric patients with
cancer ranges from 0.6% to
4.08%.7,9,15,16
The impact of the pandemic on the continuity of cancer treatment has
been a concern for physicians caring for children and adolescents with
cancer. The pandemic significantly affected pediatric oncology services
around the world, resulting in delays in diagnosis, clinical management,
and chemo- and radiotherapy treatments. These adversities were most
marked in low- and middle-income
countries.2,3,4,7,8However, once the initial difficulties were resolved, cancer treatment
could be continued safely in most
patients.14,17,18,19,20,21
It was necessary to take proactive and flexible measures in the
pediatric hematology-oncology units (PHOUs) to quickly adapt the model
of patient care, implement supervision of personal protective equipment
(PPE) to protect patients and health care personnel in order to ensure
the safety of
care.1
In Argentina, studies evaluating the effect of the COVID-19 pandemic in
children with cancer are scarce. Better knowledge of the characteristics
of affected patients using local data is a priority for the management
of these patients. The aim of this study was to describe the clinical
characteristics, treatment, and outcome of children with cancer included
in a population-based cancer registry with SARS-CoV-2 infection.