Perspective from Laura W. Musselwhite, MD
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Disclosures: The authors report no relevant financial disclosures.
May 13, 2020
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Children with cancer ‘at no higher risk’ for COVID-19 infection, morbidity

Perspective from Laura W. Musselwhite, MD
Source/Disclosures
Disclosures: The authors report no relevant financial disclosures.
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Andrew L. Kung, MD, PhD
Andrew L. Kung

Children and adolescents with cancer do not appear at higher risk for infection or morbidity from COVID-19 compared with their cancer-free counterparts, according to single-center findings published as a research letter in JAMA Oncology.

“We are reassured by these findings,” Andrew L. Kung, MD, PhD, researcher in the department of pediatrics at Memorial Sloan Kettering Cancer Center, told Healio. “Due to a lack of specific data, we were concerned that children being treated for cancer might be at heightened risk for infection by COVID-19. However, our data reassure us that children with cancer are at no higher risk for infection by COVID-19 and that the symptoms of infection are generally mild.”

Between March 10 and April 12, Kung and colleagues established a screening and testing procedure at Memorial Sloan Kettering Cancer Center that aimed to mitigate risks associated with COVID-19 infection among pediatric patients with cancer.

Researchers assessed exposure to contacts with known COVID-19 infection and the presence of COVID-19 symptoms among 178 pediatric patients (mean age, 11.1 years; 107 male) receiving treatment for cancer and their adult caregivers.

Overall, 11.2% of patients (n = 20; mean age, 15.9 years) tested positive for COVID-19, as did 17.6% (n = 13 of 74) of their adult caregivers.

Nearly one-third (29.3%; 95% CI, 18.1-42.7) of symptomatic children tested positive for COVID-19, and 95% of those infected with the virus had mild symptoms and did not require hospitalization. Among the 2.5% (95% CI, 0.5-7.1) of asymptomatic children who tested positive for COVID-19, approximately 15% of their adult caregivers tested positive.

All but three of the 20 pediatric patients with cancer and COVID-19 were male.

“One finding that was a surprise was that most COVID-19 infections were found in boys,” Kung told Healio. “In adults, there is a male skewing in patients with critical symptoms, which has been attributed in part to comorbidities that are more common in men. Our results would suggest that there is some biological basis as to why males are more likely to be infected than females.”

Although most patients who tested positive for COVID-19 had mild symptoms and were managed at home, one patient required noncritical care hospitalization and three patients were admitted for concomitant fever and neutropenia, cancer morbidity or planned chemotherapy.

Moreover, researchers observed simultaneous detection of virus in five patient/caregiver dyads, whereas five patients tested negative for COVID-19 despite close contact with caregivers who were COVID-19-positive.

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“These findings allow us to forge ahead with cancer-directed therapies,” Kung told Healio. “These results allow us to not compromise on the intensity of treatment, even [for] patients who have COVID-19 infection. As a community, the best research will be empowered by sharing and aggregating all data across our specialty, which we are committed to doing. We wanted to disseminate this early experience since it may help guide physicians in regions less affected by COVID-19.” – by Jennifer Southall

 

For more information:

Andrew L. Kung, MD, PhD, can be reached at Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY 10065; email: kunga@mskcc.org.

Disclosures: The authors report no relevant financial disclosures.