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.