INTRODUCTION
World health organization led initiative in low and middle income
countries towards improvement of survival among childhood cancer
patients1. SIOP-PODC (Pediatric Oncology in Developing
Countries) has been instrumental in developing resource adapted
treatment protocol for LMIC for six common childhood cancers [Burkitt
lymphoma , acute lymphoblastic leukemia (ALL), retinoblastoma, low grade
gliomas , Hodgkin lymphoma and Wilms tumor2. World is
in the middle of a pandemic which is posing as the biggest challenge to
public healthcare in many countries. Severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease
2019 (COVID-19)2. Since its emergence in Dec 2019, it
has resulted in 63.7 million infections and 1.4 million deaths
worldwide. India accounts for 15% of the total COVID-19 positive cases
as of November 30, 2020. The COVID-19 pandemic has created an
unprecedented global challenge in maintenance and continuity of
established treatment regimen implementation for children with cancer in
both developed as well as developing countries
settings3.
Due to their immunocompromised status, Pediatric patients constitute one
of the most vulnerable group of individuals for COVID-19 infection and
its associated morbidity & mortality as compared to general
population4. Memorial Sloan Kettering Cancer Center
and New York Presbyterian Hospital have reported 7% and 20% COVID-19
positivity among pediatric cancer patients5. In
Madrid, Incidence of COVID-19 infection in childhood cancer patients was
found to be 1.3% higher compared to the general pediatric
population6. In Turkish patients with hematological
malignancy, it was reported that case fatality rate was 13.8% compared
to 6.8% in the patients without cancer7. It was also
reported that pediatric patients with cancer may not be more vulnerable
to SARS-CoV-2 infection and resulting morbidity compared to other
children8. A multi centric and multi country survey
showed Covid-19 incidence and severity among children on anticancer
treatment might have a mild or asymptomatic COVID-199.However, in a substantial proportion of pediatric patients with
SARS-CoV2, respiratory illness may progress to severe stage requiring
hospital care10. In pediatric patients with severe
COVID-19 symptoms progression to critical illness with hypoxemic
respiratory failure can lead to prolonged ventilatory support11.
Contradicting outcome of studies from different geographical regions of
the world about COVID-19 and its associated complications in childhood
cancer patients may be a reflection of clinical as well resource setting
disparities. In view of scant availability of data from India and more
specifically from North –East India, current study was undertaken to
assess COVID-19 status and its clinical implications in the cancer
patients in children of North –East India. All the cancer patients of
children were treated at Dr. Bhubaneswar Borooah Cancer Institute,
Guwahati, Assam from July 2020 till September 2020