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