The Characteristics and Follow-Up of SARS-CoV-2 Infection in Pediatric Oncology Patients

Raghad Alkharouby; Noura Aljehani; Nasser Alsubaie; Anas Alqarni; Mohammed Hariri; Naglla Elimam; Baraa AlhajHussein; Aeshah A AlAzmi

doi:10.7759/cureus.46149

The Characteristics and Follow-Up of SARS-CoV-2 Infection in Pediatric Oncology Patients

Cureus. 2023 Sep 28;15(9):e46149. doi: 10.7759/cureus.46149. eCollection 2023 Sep.

Authors

Raghad Alkharouby¹, Noura Aljehani¹, Nasser Alsubaie¹, Anas Alqarni², Mohammed Hariri³, Naglla Elimam⁴, Baraa AlhajHussein⁵, Aeshah A AlAzmi^{6

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Affiliations

¹ College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.
² College of Medicine, University of Bisha, Bisha, SAU.
³ College of Medicine, University of Jeddah, Jeddah, SAU.
⁴ Department of Pediatric Oncology Hematology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Jeddah, SAU.
⁵ Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Jeddah, SAU.
⁶ Department of Pharmaceutical Care Services, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU.
⁷ Department of Pediatric Oncology Hematology, Bone Marrow Transplant (BMT), Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU.
⁸ King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.

Abstract

Introduction Clinical data about the first and second most prominent waves of SARS-CoV-2 among pediatric cancer patients were inconsistent. This study aims to retrospectively report the clinical characteristics and outcomes of SARS-CoV-2 infection in pediatric oncology patients. Methods This is an observational, retrospective study conducted in a tertiary care oncology center from March 2020 to May 2022. We reviewed the prevalence, severity of symptoms, and duration of positivity in relation to blood count laboratory data and mortality with a follow-up of 30 days post-infection for SARS-CoV-2. Results A total of 396 PCR tests were performed on 342 pediatric cancer patients. The overall rate of SARS-CoV-2 positivity was 43.1% (2.7% in the first wave and 95.4% in the second wave). Among 342 screened pediatric cancer patients, 72 patients had confirmed SARS-CoV-2 positivity in 92 different episodes. Nearly 59% had a mild or moderate infection, with fever and cough as the predominant presentations. The mean duration of positivity was 18.4±7.76 days. Comparing the laboratory values before and after acquiring the COVID-19 infection, only monocytes, hemoglobin, hematocrit, and platelets were statistically significantly affected, with P-values of 0.002, 0.03, 0.02, and 0.01, respectively. More than 18% of patients had grade 3 to 4 neutropenia (absolute neutrophil count=0.39±0.35) before COVID-19 infection and remained neutropenic throughout the disease, regardless of symptom severity. The mean recovery time was 13.67±8 days, which resulted in a delay in cancer treatment delivery of up to four weeks in 42.2% of patients. Conclusion Our data demonstrated that pediatric cancer patients with SARS-CoV-2 infection have a mild to moderate course of COVID-19 disease, with the majority being symptomatic, yet a great portion of our study population experienced treatment interruptions reaching up to four weeks caused by COVID-19.

Keywords: covid 19; oncology; pediatric; pediatric oncology; sars-cov-2.