Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer.
Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic / Bandyopadhyay, S; Peter, N; Lakhoo, K; Abib, Sdv; Abdelhafeez, H; Wilson, S; Pachl, M; Martin, B; Nagras, S; Sheth, M; Dominic, C; Gandhi, S; Parwani, D; Raj, R; Munezero, D; Dutta, R; Roseline, Nm; Mcclafferty, K; Nazari, A; Sriram, S; Pillarisetti, S; Nweze, Kd; Ashwinee, A; Kalra, G; Patil, P; Nathani, P; Bhullar, Kk; Elhadi, M; Khan, M; Rahim, N; Madhusudanan, S; Erhabor, J; Shirke, M; Mughal, A; Au, D; Salehi, M; Royyuru, S; Ahmed, M; Hussain, Snf; Robinson, D; Casey, A; Khan, M; Dukundane, A; Festus, K; Govind, V; Pancharatnam, R; Ochieng, L; Taylor, Eh; Nautiyal, H; Crespo, Md; Charuvila, S; Valetopoulou, A; Brar, A; Zuberi, H; Ammouze, I; Ghosh, D; Peters, Nj; Bwala, Kj; Umar, Am; Aremu, A; Suleiman, De; Aliyu, T; Saleem, A; Arshad, M; Turk, K; Altaf, S; Ogunsua, Oo; Sholadoye, Tt; Tolani, Ma; Alfa, Y; Musa, Km; Irungu, Em; Muma, K; Muma, S; Obat, M; Badran, Ys; Qasem, Ag; Ayasra, F; Alnajjar, R; Abdel-Maboud, M; Bahaa, A; Saadeldin, Am; Adwi, M; Adly, M; Elshenawy, A; Harky, A; Gentle, L; Wright, K; Luyt, J; White, O; Smith, C; Thompson, N; Smith, T; Harrison, I; Mahalik, Sk; Piplani, R; Yhoshu, E; Gupta, M; Nath, Uk; Sehrawat, A; Rajkumar, Ks; Singh, V; Abukhalaf, Sa; Mitul, Ar; Karim, S; Islam, N; Kaderalsaeiti, S; Benkhial, Fs; Almihashhish, Mmf; Burzeiza, Em; Masoud, Hm; Alshamikh, Ms; Nasef, Rmm; Masoud, Fm; Lo, Wb; Togarepi, N; Carrolan, E; O'Sullivan, Bj; Hassanin, M; Saleh, A; Bassiony, M; Qatora, M; Bahaaeldin, M; Fadel, S; El Chazli, Y; Bouderbala, A; Hamizi, K; Lorabi, S; Zekkour, Ma; Rahmoun, R; Drid, B; Abu Teir, Sn; Kadir, My; Zerizer, Y; Khernane, N; Saada, B; Elkaoune, Y; Moujtahid, H; Chaoui, G; Benaouda, H; Gounni, M; Aji, N; Hessissen, L; Monteiro, Jm; Nunes, S; Do Bom-Sucesso, M; Lal, Dr; Craig, Bt; Becktell, K; Banu, T; Alam, Ma; Pulock, Os; Aziz, Tt; Michael, V; John, Mj; Bhatti, W; John, B; Daniel, S; Dhiman, J; Mahal, H; Suroy, A; Ilic, R; Grujicic, D; Nastasovic, T; Lazic, I; Milicevic, M; Bascarevic, V; Mijalcic, R; Scepanovic, V; Stanimirovic, A; Paunovic, A; Bogdanovic, I; Kakkar, S; Kamboj, S; Singh, S; Islam, S; Morshed, Akma; Basher, Akmk; Akter, M; Rahman, Smr; Ara, Z; Ahammed, Mt; Akter, T; Nahar, K; Sayed, F; Nabi, A; Asifiqbal, M; Rana, Mm; Asaduzzaman, M; Hasanuzzaman, M; Saracoglu, Kt; Akova, E; Aydogmus, E; Kendirlioglu, Bc; Hicdonmez, T; Adhnon, A; Rana, An; Humad, H; Madasu, A; Azzam, Ay; Azab, Ma; Ghozy, S; Abbas, As; Dobs, M; Ghamry, Mam; Alhendy, M; Monteiro, J; Moses, O; Taibat, It; Jones, T; Ukoha, K; Goke, O; Ikechukwu, O; Okunlola, Ai; Chitnis, M; Nauhaus, H; Erwee, D; Brown, R; Chylinska, A; Simpson, R; Gomes, P; Padilha, Mac; de Oliveira, Ep; de Carvalho, Lg; Diz, Fl; El Kassas, M; Eldaly, U; Tawheed, A; Abdelwahab, M; Yassaad, Om; Hajar, B; Abdessamad, E; Yasser, A; Laila, H; Yahya, Fs; Al-Agele, Y; Rahul, Sk; Kumar, V; Chaubey, D; Gallardo, Mtp; Vasquez, Jem; Leon, Jlg; Yip, Ss; Karagiannidis, G; Kebudi, R; Buyukkapu, S; Govindarajan, Kk; Sambandan, K; Kayal, S; Karunanithi, G; Naredi, Bk; Jindal, B; Lami, M; Byrne, Mhv; Jasim, D; Ghattaura, H; Etchill, Ew; Rhee, D; Cooper, S; Crow, K; Drucker, M; Murphy, M; Shou, B; Siegel, A; Kara, Y; Ozdemir, Gn; Elfiky, M; El Refaee, E; Massoud, Jg; Ibrahim, Ab; Ibrahim, Rb; Abuza'Nouneh, F; Baddourah, Rm; Fahmawee, T; Al Shraideh, A; Salman, G; Alameer, E; Ali, Am; Yahia, G; Waleed, K; Ozair, A; Bajaj, A; Ojha, Bk; Singh, Kk; Anwar, A; Suresh, V; Abou Chaar, Mk; Sultan, I; Ghandour, K; Al-Dabaibeh, S; Al-Basiti, A; Ababneh, H; El-Qurneh, O; Alalawi, Y; Al Ayed, A; Hanafy, E; Al Bolowi, N; Loh, Ahp; Jacobsen, As; Barola, H; Pagaduan, Al; Fan, Jd; Elebute, Oa; Ademuyiwa, Ao; Bode, Co; Seyi-Olajide, Jo; Ladipo-Ajayi, O; Alakaloko, Fm; Ihediwa, Gc; Musa, Ko; Temiye, Eo; Oni, O; Akinsete, Am; Zarrish, J; Saleem, R; Zahid, S; Amirali, A; Nadeem, A; Tebha, Ss; Qayyum, Z; Tahir, S; Tahir, A; Khan, R; Mehmood, A; Effendi, I; Qureshi, Ti; Kumari, P; Bonna, M; Mamdouh, K; Atef, M; Faried, M; Calvagna, V; Galea, N; Axiaq, A; Schuelke, Mr; Kloeber, Ja; Owen, Rl; Roth, As; Mbwele, B; Nguma, I; Shabani, Mm; Twaha, A; Matola, B; Vojcek, A; Alrahawy, Mma; Ragab, S; Allam, Ar; Hager, Ei; Azzam, A; Ayman, A; Umuroglu, T; Saracoglu, A; Sakar, M; Cakmak, G; Sallam, I; Amira, G; Sherief, M; Sherif, A; Coelho, Sd; Ikeda, A; Portela, L; Garrigo, Mm; de Carvalho, Rv; Lobo, F; Ferman, Se; Lima, Ffd; Elhassan, Mma; Elhaj, Noy; Hamid, Hks; Ameh, Ea; Nwatah, Ve; Oyesakin, Ab; Osuigwe, An; Ekwunife, Oh; Nri-Ezedi, Ca; Umeh, Eo; Bell, N; Ogundele, Io; Adekanmbi, Af; Fatungase, Om; Obadaini, Oo; Al-Furais, S; Hemlae, H; Nay, S; Mathew, J; Ismail, Rmj; Carlesse, Fadc; Fanelli, Mca; de Souza, Fkm; Lapolla, P; Mingoli, A; Cozzi, D; Testi, Am; Musiu, P; Sapienza, P; Brachini, G; Zambon, M; Meneghini, S; Cicerchia, P; Cirillo, B; Tripathi, M; Mohindra, S; Kumar, V; Patil, Nr; Jain, R; Madan, R; Karthigeyan, M; Salunke, P; Nambi, G; Taha, Ao; Wong, Jhl; Johari, N; Shikha, A; Han, Wsp; Ahmad, Z; Lim, Yy; Idros, R; Yusof, Nm; Jaisingh, Dn; Nesrine, A; Souad, B; Malika, M; Belkacem, B; Haider, F; Al Fayez, Fn; Rahim, F; Kleinman, E; Ibelli, T; Hamilton, E; Fayngor, R; Najman, T; Karplus, G; Adam, E; Melamed, D; Paasche, C; Labib, A; Laghari, Fa; Al Balushi, Z; Al-Rawas, Aas; Al Sharqi, A; Alshabibi, As; Al Bulushi, I; Alshahri, M; Almirza, A; Al Hamadani, O; Al Sharqi, J; Al Shamsi, A; Dawud, B; Al Sibai, S; Abdul-Mumin, A; Fuseini, Hy; Kwarteng, Pg; Abdulai, Ab; Kunfah, Smp; Bonsaana, Gb; Ajinkpang, S; Der, Em; Abantanga, Fa; Kpiniong, Mj; Hattor, Ka; Bimpong, Ka; Elbahnasawy, M; Abdelsalam, S; Samir, A; Baertschiger, Rm; Matei, Ac; Zani, A; Samad, L; Zuberi, Hk; Nadeem, K; Khayyam, N; Imran, Fa; Zia, N; Muhammad, S; Raza, Mr; Khan, Mr; Hamdan, A; Omran, A; Moussa, A; Gawrieh, B; Salloum, H; Ahmed, A; Mazloum, A; Abodest, A; Ali, N; Hraib, M; Khoury, V; Almjersah, A; Deeb, Ma; Alkhalil, Maa; Ahmed, A; Shater, W; Alelayan, Af; Guzlan, A; Bouhuwaish, A; Abdulkarim, A; Abdulwahed, E; Biala, M; Ghamgh, R; Alamre, A; Shelft, M; Albanna, Aam; Tawel, H; Hatzipantelis, E; Tragiannidis, A; Tsotridou, E; Galli-Tsinopoulou, A; Lawal, Ta; Egbuchulem, Ki; Ogundoyin, Oo; Olulana, Id; Brown, Bj; Afolaranmi, Oj; Fehintola, Ab; Heuer, A; Nitschke, C; Boettcher, M; Priemel, M; Viezens, L; Stangenberg, M; Dreimann, M; Reiter, A; Meyer, J; Kopke, L; Frosch, Kh; Nasir, Aa; Ibrahim, Koo; Ademola-Popoola, Ds; Sayomi, Ot; Bdurrzzaq, A; Adeyeye, Aa; Omokanye, Ko; Rahman, Loa; Bamidele, Oo; Azeez, Sa; Akinoso, A; Adegboye, Mo; Almasri, M; Ali, S; Olaosebikan, R; Muthukumar, A; Nuhu-Koko, A; Jibrin, B; Olalekan, Al; Lukong, Cs; Ajayi, Ei; Ruzgar, Nm; Levinson, R; Kala, S; Ullrich, S; Christison-Lagay, E; Mortada, As; Ebada, Ma; Solimam, Esa; Abualkher, K; Yousf, Ame; Holail, Mm; Almowafy, Rm; Aziz, Daa; Latiff, Za; Alias, H; Loh, Ck; Lau, D; Zaman, Ask; Olori, S; Offiong, U; Mshelbwala, Pm; Patrick, Fa; Umar, Am; Thankgod, No; Nah, Sa; Ng, Yj; Zubaidi, Sa; Shinondo, P; Ngongola, A; Bvulani, B; Patel, A; Danfodiyo, U; Guillen, G; Lopez, S; Molino, Ja; Velasco, P; Elmandouh, O; Hamam, O; Elmandouh, R; Gallo, G. - In: BMJ GLOBAL HEALTH. - ISSN 2059-7908. - 7:10(2022). [10.1136/bmjgh-2022-008797]
Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic
Bandyopadhyay, S ; Peter, N; Lakhoo, K; Abib, SDV; Abdelhafeez, H; Wilson, S; Pachl, M; Martin, B; Nagras, S; Sheth, M; Dominic, C; Gandhi, S; Parwani, D; Raj, R; Munezero, D; Dutta, R; Roseline, NM; McClafferty, K; Nazari, A; Sriram, S; Pillarisetti, S; Nweze, KD; Ashwinee, A; Kalra, G; Patil, P; Nathani, P; Bhullar, KK; Elhadi, M; Khan, M; Rahim, N; Madhusudanan, S; Erhabor, J; Shirke, M; Mughal, A; Au, D; Salehi, M; Royyuru, S; Ahmed, M; Hussain, SNF; Robinson, D; Casey, A; Khan, M; Dukundane, A; Festus, K; Govind, V; Pancharatnam, R; Ochieng, L; Taylor, EH; Nautiyal, H; Crespo, MD; Charuvila, S; Valetopoulou, A; Brar, A; Zuberi, H; Ammouze, I; Ghosh, D; Peters, NJ; Bwala, KJ; Umar, AM; Aremu, A; Suleiman, DE; Aliyu, T; Saleem, A; Arshad, M; Turk, K; Altaf, S; Ogunsua, OO; Sholadoye, TT; Tolani, MA; Alfa, Y; Musa, KM; Irungu, EM; Muma, K; Muma, S; Obat, M; Badran, YS; Qasem, AG; Ayasra, F; Alnajjar, R; Abdel-Maboud, M; Bahaa, A; Saadeldin, AM; Adwi, M; Adly, M; Elshenawy, A; Harky, A; Gentle, L; Wright, K; Luyt, J; White, O; Smith, C; Thompson, N; Smith, T; Harrison, I; Mahalik, SK; Piplani, R; Yhoshu, E; Gupta, M; Nath, UK; Sehrawat, A; Rajkumar, KS; Singh, V; Abukhalaf, SA; Mitul, AR; Karim, S; Islam, N; KaderAlsaeiti, S; Benkhial, FS; Almihashhish, MMF; Burzeiza, EM; Masoud, HM; Alshamikh, MS; Nasef, RMM; Masoud, FM; Lo, WB; Togarepi, N; Carrolan, E; O'Sullivan, BJ; Hassanin, M; Saleh, A; Bassiony, M; Qatora, M; Bahaaeldin, M; Fadel, S; El Chazli, Y; Bouderbala, A; Hamizi, K; Lorabi, S; Zekkour, MA; Rahmoun, R; Drid, B; Abu Teir, SN; Kadir, MY; Zerizer, Y; Khernane, N; Saada, B; Elkaoune, Y; Moujtahid, H; Chaoui, G; Benaouda, H; Gounni, M; Aji, N; Hessissen, L; Monteiro, JM; Nunes, S; Do Bom-Sucesso, M; Lal, DR; Craig, BT; Becktell, K; Banu, T; Alam, MA; Pulock, OS; Aziz, TT; Michael, V; John, MJ; Bhatti, W; John, B; Daniel, S; Dhiman, J; Mahal, H; Suroy, A; Ilic, R; Grujicic, D; Nastasovic, T; Lazic, I; Milicevic, M; Bascarevic, V; Mijalcic, R; Scepanovic, V; Stanimirovic, A; Paunovic, A; Bogdanovic, I; Kakkar, S; Kamboj, S; Singh, S; Islam, S; Morshed, AKMA; Basher, AKMK; Akter, M; Rahman, SMR; Ara, Z; Ahammed, MT; Akter, T; Nahar, K; Sayed, F; Nabi, A; AsifIqbal, M; Rana, MM; Asaduzzaman, M; Hasanuzzaman, M; Saracoglu, KT; Akova, E; Aydogmus, E; Kendirlioglu, BC; Hicdonmez, T; Adhnon, A; Rana, AN; Humad, H; Madasu, A; Azzam, AY; Azab, MA; Ghozy, S; Abbas, AS; Dobs, M; Ghamry, MAM; Alhendy, M; Monteiro, J; Moses, O; Taibat, IT; Jones, T; Ukoha, K; Goke, O; Ikechukwu, O; Okunlola, AI; Chitnis, M; Nauhaus, H; Erwee, D; Brown, R; Chylinska, A; Simpson, R; Gomes, P; Padilha, MAC; de Oliveira, EP; de Carvalho, LG; Diz, FL; El Kassas, M; Eldaly, U; Tawheed, A; Abdelwahab, M; Yassaad, OM; Hajar, B; Abdessamad, E; Yasser, A; Laila, H; Yahya, FS; Al-Agele, Y; Rahul, SK; Kumar, V; Chaubey, D; Gallardo, MTP; Vasquez, JEM; Leon, JLG; Yip, SS; Karagiannidis, G; Kebudi, R; Buyukkapu, S; Govindarajan, KK; Sambandan, K; Kayal, S; Karunanithi, G; Naredi, BK; Jindal, B; Lami, M; Byrne, MHV; Jasim, D; Ghattaura, H; Etchill, EW; Rhee, D; Cooper, S; Crow, K; Drucker, M; Murphy, M; Shou, B; Siegel, A; Kara, Y; Ozdemir, GN; Elfiky, M; El Refaee, E; Massoud, JG; Ibrahim, AB; Ibrahim, RB; AbuZa'nouneh, F; Baddourah, RM; Fahmawee, T; Al Shraideh, A; Salman, G; Alameer, E; Ali, AM; Yahia, G; Waleed, K; Ozair, A; Bajaj, A; Ojha, BK; Singh, KK; Anwar, A; Suresh, V; Abou Chaar, MK; Sultan, I; Ghandour, K; Al-Dabaibeh, S; Al-Basiti, A; Ababneh, H; El-Qurneh, O; Alalawi, Y; Al Ayed, A; Hanafy, E; Al Bolowi, N; Loh, AHP; Jacobsen, AS; Barola, H; Pagaduan, AL; Fan, JD; Elebute, OA; Ademuyiwa, AO; Bode, CO; Seyi-Olajide, JO; Ladipo-Ajayi, O; Alakaloko, FM; Ihediwa, GC; Musa, KO; Temiye, EO; Oni, O; Akinsete, AM; Zarrish, J; Saleem, R; Zahid, S; Amirali, A; Nadeem, A; Tebha, SS; Qayyum, Z; Tahir, S; Tahir, A; Khan, R; Mehmood, A; Effendi, I; Qureshi, TI; Kumari, P; Bonna, M; Mamdouh, K; Atef, M; Faried, M; Calvagna, V; Galea, N ;Axiaq, A; Schuelke, MR; Kloeber, JA; Owen, RL; Roth, AS; Mbwele, B; Nguma, I; Shabani, MM; Twaha, A; Matola, B; Vojcek, A; Alrahawy, MMA; Ragab, S; Allam, AR; Hager, EI; Azzam, A; Ayman, A; Umuroglu, T; Saracoglu, A; Sakar, M; Cakmak, G; Sallam, I; Amira, G; Sherief, M; Sherif, A; Coelho, SD; Ikeda, A; Portela, L; Garrigo, MM; de Carvalho, RV; Lobo, F; Ferman, SE; Lima, FFD; Elhassan, MMA; Elhaj, NOY; Hamid, HKS; Ameh, EA; Nwatah, VE; Oyesakin, AB; Osuigwe, AN; Ekwunife, OH; Nri-Ezedi, CA; Umeh, EO; Bell, N; Ogundele, IO; Adekanmbi, AF; Fatungase, OM; Obadaini, OO; Al-Furais, S; Hemlae, H; Nay, S; Mathew, J; Ismail, RMJ; Carlesse, FADC; Fanelli, MCA; de Souza, FKM; Lapolla, P ;Mingoli, A ;Cozzi, D ;Testi, AM ;Musiu, P ;Sapienza, P ;Brachini, G ;Zambon, M ;Meneghini, S ;Cicerchia, P ;Cirillo, B; Tripathi, M; Mohindra, S; Kumar, V ;Patil, NR; Jain, R; Madan, R; Karthigeyan, M; Salunke, P; Nambi, G; Taha, AO; Wong, JHL; Johari, N; Shikha, A; Han, WSP; Ahmad, Z; Lim, YY; Idros, R; Yusof, NM; Jaisingh, DN; Nesrine, A; Souad, B; Malika, M; Belkacem, B; Haider, F; Al Fayez, FN; Rahim, F; Kleinman, E; Ibelli, T; Hamilton, E; Fayngor, R; Najman, T; Karplus, G; Adam, E; Melamed, D; Paasche, C; Labib, A; Laghari, FA; Al Balushi, Z; Al-Rawas, AAS; Al Sharqi, A; AlShabibi, AS; Al Bulushi, I; Alshahri, M; AlMirza, A; Al Hamadani, O; Al Sharqi, J; Al Shamsi, A; Dawud, B; Al Sibai, S; Abdul-Mumin, A; Fuseini, HY; Kwarteng, PG; Abdulai, AB; Kunfah, SMP; Bonsaana, GB; Ajinkpang, S; Der, EM; Abantanga, FA; Kpiniong, MJ; Hattor, KA; Bimpong, KA; Elbahnasawy, M; Abdelsalam, S; Samir, A; Baertschiger, RM; Matei, AC; Zani, A; Samad, L; Zuberi, HK; Nadeem, K; Khayyam, N; Imran, FA; Zia, N; Muhammad, S; Raza, MR; Khan, MR; Hamdan, A; Omran, A; Moussa, A; Gawrieh, B; Salloum, H; Ahmed, A; Mazloum, A; Abodest, A; Ali, N; Hraib, M; Khoury, V; Almjersah, A; Deeb, MA; Alkhalil, MAA; Ahmed, A; Shater, W; Alelayan, AF; Guzlan, A; Bouhuwaish, A; Abdulkarim, A; Abdulwahed, E; Biala, M; Ghamgh, R; Alamre, A; Shelft, M; Albanna, AAM; Tawel, H; Hatzipantelis, E; Tragiannidis, A; Tsotridou, E; Galli-Tsinopoulou, A; Lawal, TA; Egbuchulem, KI; Ogundoyin, OO; Olulana, ID; Brown, BJ; Afolaranmi, OJ; Fehintola, AB; Heuer, A; Nitschke, C; Boettcher, M; Priemel, M; Viezens, L; Stangenberg, M; Dreimann, M; Reiter, A; Meyer, J; Kopke, L; Frosch, KH; Nasir, AA; Ibrahim, KOO; Ademola-Popoola, DS; Sayomi, OT; Bdurrzzaq, A; Adeyeye, AA; Omokanye, KO; Rahman, LOA; Bamidele, OO; Azeez, SA; Akinoso, A; Adegboye, MO; Almasri, M; Ali, S; Olaosebikan, R; Muthukumar, A; Nuhu-Koko, A; Jibrin, B; Olalekan, AL; Lukong, CS; Ajayi, EI; Ruzgar, NM; Levinson, R; Kala, S; Ullrich, S; Christison-Lagay, E; Mortada, AS; Ebada, MA; Solimam, ESA; Abualkher, K; Yousf, AME; Holail, MM; Almowafy, RM; Aziz, DAA; Latiff, ZA; Alias, H; Loh, CK; Lau, D; Zaman, ASK; Olori, S; Offiong, U; Mshelbwala, PM; Patrick, FA; Umar, AM; ThankGod, NO; Nah, SA; Ng, YJ; Zubaidi, SA; Shinondo, P; Ngongola, A; Bvulani, B; Patel, A; Danfodiyo, U; Guillen, G; Lopez, S; Molino, JA; Velasco, P; Elmandouh, O; Hamam, O; Elmandouh, R; Gallo, G
2022
Abstract
Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer.
Citazione
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[10.1136/bmjgh-2022-008797]
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