Adolescents and young adults (AYA) with cancer: the clinical course of COVID-19 infections

Julie A Wolfson; Elizabeth S Davis; Aniket Saha; Isaac Martinez; David McCall; Prachi Kothari; Julienne Brackett; David S Dickens; Alissa R Kahn; Carla Schwalm; Archana Sharma; Joshua Richman; Branko Cuglievan; POCC Consortium; Smita Bhatia; Chen Dai; Jennifer M Levine; Emily E Johnston

doi:10.1093/jnci/djae085

Adolescents and young adults (AYA) with cancer: the clinical course of COVID-19 infections

J Natl Cancer Inst. 2024 Apr 16:djae085. doi: 10.1093/jnci/djae085. Online ahead of print.

Authors

Julie A Wolfson^{1

2}, Elizabeth S Davis³, Aniket Saha⁴, Isaac Martinez², David McCall⁵, Prachi Kothari⁶, Julienne Brackett⁷, David S Dickens⁸, Alissa R Kahn⁹, Carla Schwalm¹⁰, Archana Sharma¹¹, Joshua Richman^{2

12}, Branko Cuglievan⁵; POCC Consortium; Smita Bhatia^{1

2}, Chen Dai², Jennifer M Levine¹², Emily E Johnston^{1

2}

Affiliations

¹ Pediatric Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
² Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL, USA.
³ Department of Surgery, Boston University/Boston Medical Center, Boston, MA, USA.
⁴ Prisma Health Upstate/BI-LO Charities Children's Cancer Center/Greenville Health System, Greenville, SC, USA.
⁵ Department of Pediatrics, MD Anderson Cancer Center, Houston, TX, USA.
⁶ Pediatric Hematology-Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
⁷ Pediatric Hematology-Oncology, Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA.
⁸ Pediatric Hematology-Oncology, Department of Pediatrics, University of Iowa, Iowa City, IA, USA.
⁹ Pediatric Hematology-Oncology, Department of Pediatrics, Saint Joseph's University Medical Center, Paterson, NJ, USA.
¹⁰ Pediatric Hematology-Oncology, Department of Pediatrics, Bronson Methodist Hospital, Kalamazoo, MI, USA.
¹¹ Pediatric Hematology-Oncology, Department of Pediatrics, Rutgers Cancer Institute, New Brunswick, NJ, USA.
¹² Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC, USA.

PMID: 38627241
DOI: 10.1093/jnci/djae085

Abstract

Adolescents and Young Adults (AYAs: 15-39 y) with cancer face unique vulnerabilities, yet remain under-represented on clinical trials, including adult registries of COVID-19 in cancer (AYAs: 8-12%). Thus, we leveraged the Pediatric Oncology COVID-19 Case Report (POCC) to examine the clinical course of COVID-19 among AYAs with cancer. POCC collects de-identified clinical and sociodemographic data regarding 0-39yo with cancer (AYAs = 37%) and COVID-19 from >100 institutions. Between 04/01/2020-11/28/2023, 191 older AYAs [22-39y] and 640 younger AYAs [15-21y] were captured. Older AYAs were less often hospitalized (p < .001), admitted to the intensive care unit (ICU, p = .02), and/or required respiratory support (p = .057). In multivariable analyses, older AYAs faced 80% lower odds of ICU admission but 2.3-times greater odds of changes to cancer-directed therapy. Unvaccinated patients had 5.4-times higher odds of ICU admission. Among AYAs with cancer, the COVID-19 course varies by age. These findings can inform pediatric/adult oncology teams surrounding COVID-19 management and prevention.