Mahmoud Hammad

and 15 more

Background: Sufficient data pertaining to the impact of the COVID-19 pandemic on pediatric cancer patients is still currently lacking. The main aim of this prospective study was to describe clinical management and outcomes of COVID-19 in this vulnerable group. Methods: Conducted between May 1st and November 30, 2020, this study included 76 pediatric oncology patients with confirmed COVID-19. Remdesivir (RDV) was the antiviral therapy used. Results: The median age of patients was 9 years. Sixty patients were on first line treatment. Haematological malignancies constituted 86.8% of patients. 35.4% of cases had severe to critical infections. The commonest presentation was fever (93.4%). Chemotherapy was delayed in 59.2% of cases and doses were modified in 30.2%. The sixty-day overall survival (OS) stood at 86.6%, with mortalities occurring only among critically ill patients. Of sixteen acute leukaemia patients in the first induction phase of treatment, 13 survived and 10 achieved induction remission. A negative PCR within 2 weeks and improvement of radiological findings were statistically related to disease severity (p=0.008 and, 0.002 respectively). Better OS was associated with regression of radiological findings after 30 days from infection (p=0.002). Of the forty-five cases who received RDV, 70% were severe to critically ill cases with comparable outcome to patients who did not receive the drug. Conclusions: Most pediatric cancer patients with COVID-19 should have good clinical outcomes, except for those with critical form of infections. Newly diagnosed cases seem to tolerate induction therapy alongside COVID-19 treatment. RDV was well tolerated with no serious adverse events observed.