Objectives Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. Design A multicentre, international, collaborative cohort study. Setting 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. Participants Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin’s lymphoma, Hodgkin lymphoma, Wilms’ tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. Main outcome measure All-cause mortality at 30 days and 90 days. Results 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). Conclusions The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally.
Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study / Bandyopadhyay, Soham; Peter, Noel; Lakhoo, Kokila; Vieira Abib, Simone de Campos; Abdelhafeez, Hafeez; Wilson, Shaun; Pachl, Max; Martin, Benjamin; Nagras, Sonal; Sheth, Mihir; Dominic, Catherine; Gandhi, Suraj; Parwani, Divya; Raj, Rhea; Munezero, Diella; Dutta, Rohini; Roseline, Nsimire Mulanga; Mcclafferty, Kellie; Nazari, Armin; Sriram, Smrithi; Pillarisetti, Sai; Nweze, King-David; Ashwinee, Aishwarya; Kalra, Gul; Patil, Poorvaprabha; Nathani, Priyansh; Bhullar, Khushman Kaur; Elhadi, Muhammed; Khan, Maryam; Rahim, Nehal; Madhusudanan, Shweta; Erhabor, Joshua; Shirke, Manasi; Mughal, Aishah; Au, Darica; Salehi, Mahan; Royyuru, Sravani; Ahmed, Mohamed; Hussain, Syeda Namayah Fatima; Robinson, Daniel; Casey, Anna; Khan, Mehdi; Dukundane, Alexandre; Festus, Kwizera; Govind, Vaishnavi; Pancharatnam, Rohan; Ochieng, Lorraine; Taylor, Elliott H.; Nautiyal, Hritik; Crespo, Marta de Andres; Charuvil, Somy; Valetopoulou, Alexandra; Ravi, Krithi; Jalloh, Fatumata; Badwi, Nermin; Shah, Shahnur; Rajpal, Rohini; Rana, Masooma; Qadir, Muskaan Abdul; Uwiringiyimana, Emmanuel; Azzam, Abdelrahman; Fanelli, Mayara; Ataide Gomes, Gustavo Mendonca; Buarque, Igor Lima; Guerini, Isadora Schwaab; Bouderbala, Anfel; Alfurais, Sarah; Gamal, Mohamed; Hijazi, Yara; Tailakh, Shatha; Al-Naggar, Hamza; Douba, Zain; Elejla, Sewar; Eldaly, Abdullah; Sharashi, Ekram; Mansour, Ahmad; Elyan, Tamara; Nesrine, Aouabed; Ayman, Ammar; Zazo, Aya; Bonna, Mohamed; Lorabi, Safia; Alalami, Hassan; Emam, Rawan Yasser; Bwala, Kefas John; Umar, A. M.; Aremu, Abdurahaman; Suleiman, Dauda E.; Aliyu, Tybat; Saleem, Ayesha; Arshad, Muhammad; Turk, Kashaf; Altaf, Sadaf; Ogunsua, Oluseyi Oyebode; Sholadoye, Tunde Talib; Tolani, Musliu Adetola; Alfa, Yakubu; Mubarak, Keffi; Irungu, Eric Mwangi; Muma, Ken; Muma, Sarah; Obat, Mitchelle; Sameh, Youssef; Qasem, Abdulrahman Ghassan; Ayasra, Faris; Alnajjar, Reema; Abdel-Maboud, Mohamed; Bahaa, Abdelrahman; Saadeldin, Ayat M.; Adwi, Mohamed; Adly, Mahmoud; Elshenawy, Abdallah; Harky, Amer; Gentle, Leanne; Wright, Kirstie; Luyt, Jessica; White, Olivia; Smith, Charlotte; Thompson, Nathan; Smith, Thomas; Harrison, Imogen; Mitul, Ashrarur Rahman; Karim, Sabbir; Islam, Nazmul; Alsaeiti, Sara Kader; Benkhial, Fatma Saleh; Almihashhish, Mohammed Miftah Faraj; Burzeiza, Eman Salem Muftah; Masoud, Hend Mohammed; Alshamikh, Mabroukah Saeid; Nasef, Rajaari Mohammed; Mohammed, Fatma; Lo, William B.; Togarepi, Nyararai; Carrolan, Elaine; O'Sullivan, Benjamin J.; Hassanin, Mohamed; Saleh, Ahmed; Bassiony, Mahmoud; Qatora, Mostafa; Bahaaeldin, Mohamed; Fadel, Shady; El Chazli, Yasmine; Hamizi, Kamel; Zekkour, Mehdi Anouar; Rahmoun, Rima; Drid, Boutheyna; Abu Teir, Salma Naje; Kadir, Mohamed Yazid; Zerizer, Yassine; Khernane, Nacer; Saada, Brahim; Ammouze, Imane; Elkaoune, Yahya; Moujtahid, Hajar; Chaoui, Ghita; Benaouda, Hajar; Gounni, Meryem; Aji, Narjiss; Hessissen, Laila; Monteiro, Joana Mafalda; Nunes, Susana; do Bom-Sucesso, Maria; Lal, Dave R.; Craig, Brian T.; Becktell, Kerri; Banu, Tahmina; Alam, Md Afruzul; Pulock, Orindom Shing; Aziz, Tasmiah Tahera; Ilic, Rosanda; Grujicic, Danica; Nastasovic, Tijana; Lazic, Igor; Milicevic, Mihailo; Bascarevic, Vladimir; Mijalcic, Radovan; Scepanovic, Vuk; Stanimirovic, Aleksandar; Islam, Shahnoor; Basher, Akm Amirul Morshed A. K. M. Khairul; Akter, Mehnaz; Rahman, S. M. Rezanur; Ara, Zannat; Ahammed, Mohammed Tanvir; Akter, Tania; Nahar, Kamrun; Sayed, Fatema; Saracoglu, Kemal Tolga; Akova, Elif; Aydogmus, Evren; Kendirlioglu, Bekir Can; Hicdonmez, Tufan; Adhnon, Arshiya; Rana, Asim Noor; Humad, Hani; Madasu, Anjan; Azzam, Ahmed Y.; Azab, Mohammed A.; Ghozy, Sherief; Salah, Alzhraa; Moses, Olanrewaju; Taibat, Ibiyeye Taiye; Jones, Taiwo; Ukoha, Kalu; Goke, Olagundoye; Ikechukwu, Okorie; Idowu, Abiodun; Chitnis, Milind; Nauhaus, Helga; Erwee, Danelle; Brown, Robyn; Chylinska, Agata; Simpson, Robin; Gomes, Prasanna; Ciriaco Padilha, Marco Aurelio; de Oliveira Junior, Elvercio Pereira; de Carvalho, Lucas Garschagen; Diz, Fabiola Leonelli; El Kassas, Mohamed; Eldaly, Usama; Tawheed, Ahmed; Abdelwahab, Mohamed; Yassaad, Oudrhiri Mohammed; Hajar, Bechri; Abdessamad, El Ouahabi; Yasser, Arkha; Laila, Hessissen; Yahya, Farah Sameer; Al-Agele, Yasir; Gallardo, Maria Teresa Pena; Vasquez, Jacqueline Elizabeth Montoya; Leon, Juan Luis Garcia; Yip, Sebastian Shu; Lami, Mariam; Byrne, ; Matthew, H.; V, ; Jasim, Duha; Ghattaura, Harmit; Etchill, Eric W.; Rhee, Daniel; Cooper, Stacy; Crow, Kevin; Drucker, Morgan; Murphy, Megan; Shou, Benjamin; Siegel, Alan; Kara, Yasin; Ozdemir, Gul Nihal; Elfiky, Mahmoud; Refaee, Ehab El; Massoud, John George; Ibrahim, Ayah Bassam; Ibrahim, Ruaa Bassam; Abu Za'nouneh, Faris; Baddourah, Ranya M.; Fahmawee, Toqa; Al-Shraideh, Ayah; Salman, Ghazwani; Alameer, Ehab; Ali, Al-Mudeer; Yahia, Ghazwani; Waleed, Khozairi; Abou Chaar, Mohamad K.; Sultan, Iyad; Ghandour, Khalil; Al-Dabaibeh, Shaima; Al-Basiti, Ammar; Ababneh, Hazim; El-Qurneh, Omaima; Alalawi, Yousef; Al Ayed, Ahmad; Hanafy, Ehab; Bolowi, Naif Al; Loh, Amos H. P.; Jacobsen, Anette S.; Barola, Heidi; Pagaduan, Aubrey L.; Fan, Jingdan; Elebute, Olumide Abiodun; Ademuyiwa, Adesoji O.; Bode, Christopher O.; Seyi-Olajide, Justina O.; Ladipo-Ajayi, Oluwaseun; Alakaloko, Felix M.; Ihediwa, George C.; Temiye, Edamisan O.; Zarrish, Janita; Saleem, Ramsha; Zahid, Soha; Amirali, Atiqa; Nadeem, Ahsan; Tebha, Sameer Saleem; Qayyum, Zonaira; Tahir, Sana; Tahir, Anneqa; Qureshi, Taimur Iftikhar; Kumari, Pooja; Calvagna, Victor; Galea, Nathalie; Axiaq, Ariana; Schuelke, Matthew R.; Kloeber, Jake A.; Owen, Robert L.; Roth, Alexander S.; Yang, Catherine; Barnett, J. Hudson; Jay, Lucien P.; Wyatt, Kirk David; Medical, Paul J. Galardy; Vojcek, Agnes; Alrahawy, Mahmoud Maher Abdelnaby; Ragab, Seham M.; Allam, Abdallah R.; Hager, Eman Ibrahim; Sakar, Mustafa; Cakmak, Gul; Sallam, Ibrahim; Amira, Gamal; Sherief, Mohamed; Sherif, Ahmed; Coelho, Simone de Oliveira; Ikeda, Arissa; Portela, Licia; Garrigo, Marianne Monteiro; de Carvalho, Ricardo Vianna; Lobo, Fernanda; Ferman, Sima Ester; Lima, Fernanda Ferreira da Silva; Elhassan, Moawia Mohammed Ali; Elhaj, Nada Osman Yousif; Hamid, Hytham K. S.; Ameh, Emmanuel A.; Nwatah, Vincent E.; Nnamdi, Adewumi B. Oyesakin; Osuigwe, Andrew Nwankwo; Ekwunife, Okechukwu Hyginus; Nri-Ezedi, Chisom Adaobi; Umeh, Eric Okechukwu; Bell, Nellie; Ogundele, Ibukunolu Olufemi; Adekanmbi, Abiodun Folashade; Fatungase, Olubunmi Motunrayo; Obafemi, Olubunmi; Al-Furais, Sarah; Hemlae, Humaida; Nay, Sreylis; Mathew, John; de Moraes Costa Carlesse, Fabianne Altruda; Fanelli, Mayara Caroline Amorim; Kelly, Fernanda; Lapolla, Pierfrancesco; Mingoli, Andrea; Cozzi, Denis; Testi, Anna Maria; Musiu, Paolo; Sapienza, Paolo; Brachini, Gioia; Zambon, Martina; Meneghini, Simona; Abdenour, Abdulrahman Omar Taha Saadna Mohamed; Souad, Bouaoud; Malika, Mebarki; Belkacem, Bioud; Meelad, Ayman; Salim, Hajier; Haider, Fayza; Al Fayez, Fatema Naser; Rahim, Fakher; Abdul-Mumin, Alhassan; Fuseini, Halwani Yaninga; Kwarteng, Peter Gyamfi; Abdulai, Abubakari Bawa; Kunfah, Sheba Mary Pognaa; Bonsaana, Gilbert B.; Ajinkpang, Stephanie; Der, Edmund M.; Abantanga, Francis A.; Elbahnasawy, Mohamed; Abdelsalam, Sherief; Samir, Ahmed; Baertschiger, Reto M.; Brar, Amanpreet; Matei, Andreea C.; Zani, Augusto; Samad, Lubna; Zuberi, Hira Khalid; Nadeem, Kishwer; Khayyam, Naema; Imran, Fatima Ambreen; Zia, Nida; Muhammad, Sadia; Raza, Muhammad Rafie; Khan, Muhammad Rahil; Hamdan, Alaa; Omran, Ammar; Moussa, Ahmed; Gawrieh, Bardisan; Salloum, Hassan; Ahmed, Alaa; Mazloum, Abdeljawad; Abodest, Ali; Ali, Nisreen; Bouhuwaish, Ahmad; Abdulkarim, Alqasim; Abdulwahed, Eman; Biala, Marwa; Ghamgh, Reem; Alamre, Amani; Shelft, Marwa; Albanna, Asmaa A. M.; Tawel, Hoda; Hatzipantelis, Emmanuel; Tragiannidis, Athanasios; Tsotridou, Eleni; Galli-Tsinopoulou, Assimina; Aziz, Dayang Anita Abdul; Latiff, Zarina Abdul; Alias, Hamidah; Loh, C-Khai; Lau, Doris; Zaman, Azrina Syarizad Khutubul; Vuille-dit-Bille, Raphael N.; Holland-Cunz, Stefan G.; Allafi, Nima; Lawal, Taiwo Akeem; Egbuchulem, Kelvin Ifeanyichukwu; Ogundoyin, Olakayode Olaolu; Olulana, Isaac Dare; Brown, Biobele J.; Afolaranmi, Oluwasegun Joshua; Fehintola, Abdulbasit; Heuer, Annika; Nitschke, Christine; Boettcher, Michael; Priemel, Matthias; Viezens, Lennart; Stangenberg, Martin; Dreimann, Marc; Reiter, Alonja; Meyer, Jasmin; Olori, Samson; Offiong, Uduak; Mshelbwala, Philip Mari; Patrick, Fashie Andrew; Umar, Aminu Muhammed; Thankgod, Otene; Nasir, Abdulrasheed A.; Ibrahim, Kazeem O. O.; Ademola-Popoola, Dupe S.; Sayomi, Olayinka T.; Abdurrzzaq, Alege; Adeyeye, Ademola A.; Omokanye, Khadijah O.; Abdur-Rahman, Lukman O.; Bamidele, Olubisi Olutosin; Nah, Shireen Anne; Ng, Yuki Julius; Zubaidi, Syukri Ahmad; Almasri, Murad; Ali, Sara; Olaosebikan, Rasaq; Muthukumar, Akila; Shinondo, Patricia; Ngongola, Amon; Bvulani, Bruce; Patel, Azad; Nuhu-Koko, Abdullahi; Jibrin, Baba; Olalekan, Ajiboye L.; Lukong, Christopher S.; Vall, Ezekiel I. Ajayi; Guillen, Gabriela; Lopez, Sergio; Molino, Jose Andres; Velasco, Pablo; Elmandouh, Omar; Hamam, Omar; Elmandouh, Rim; Ruzgar, Nensi Melissa; Levinson, Rachel; Kala, Shashwat; Ullrich, Sarah; Christison-Lagay, Emily; Mortada, Aya Sabry; Ebada, Mahmoud Ahmed; Solimam, Eman Seif Alnaser; Abualkher, Khaled; Yousf, Amr Mohammed Elsayed; Holail, Mohamed Mohamed; Mohamed, Reem; Ismail, R. M. Jeffri; Kpiniong, Mary Joan; Hattor, Kingsley Aseye; Bimpong, Kingsley Appiah; Gallo, Gaetano; Cirillo, Bruno; Global Health Research Group on Children’s NonCommunicable Diseases, Collaborative. - In: BMJ OPEN. - ISSN 2044-6055. - 12:4(2022). [10.1136/bmjopen-2021-054690]
Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study
Mansour, Ahmad;Lapolla, PierfrancescoMembro del Collaboration Group
;Mingoli, AndreaMembro del Collaboration Group
;Cozzi, DenisMembro del Collaboration Group
;Testi, Anna Maria;Musiu, PaoloMembro del Collaboration Group
;Sapienza, PaoloMembro del Collaboration Group
;Brachini, GioiaMembro del Collaboration Group
;Zambon, MartinaMembro del Collaboration Group
;Meneghini, SimonaMembro del Collaboration Group
;Zani, Augusto;Gallo, GaetanoMembro del Collaboration Group
;Cirillo, BrunoMembro del Collaboration Group
;
2022
Abstract
Objectives Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. Design A multicentre, international, collaborative cohort study. Setting 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. Participants Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin’s lymphoma, Hodgkin lymphoma, Wilms’ tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. Main outcome measure All-cause mortality at 30 days and 90 days. Results 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). Conclusions The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally.| File | Dimensione | Formato | |
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Bandyopadhyay_Impact-of-the-COVID-19-pandemic_2022.pdf
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Note: Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study
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