Niveditha Balakumar, MBBS
Assistant Professor
Children's Hospital of San Antonio, United States
Disclosure information not submitted.
.jpg "Meghana Nadiger, MD photo")
Meghana Nadiger, MD
Children's Hospital of Illinois
Peoria, Illinois
Disclosure information not submitted.
Prithvi Raj Sendi, MD
Nicklaus Children's Hospital
Miami, Florida
Disclosure information not submitted.
Balagangadhar Totapally, MBBS, MD, DCH, MRCP, FAAP, FCCP, FCCM
Chief, Division of Critical Care Medicine. Program Director, Critical Care Fellowship Program
Nicklaus Children's Hospital, United States
Disclosure information not submitted.
Utpal Bhalala, MD, , FCCM
Pediatric Intensivist, Associate Professor, Research Advisor
Driscoll Children's Hospital
Corpus Christi
Disclosure information not submitted.
Title: Characterization of Pediatric Oncology Patients Affected by COVID-19 Using SCCM VIRUS Registry
Introduction: Multicenter data on the characteristics and outcomes of children with cancer diagnosis hospitalized with COVID-19 are limited. The objective of this study was to describe the characteristics, ICU interventions, and outcomes in pediatric patients admitted with COVID-19 with any oncologic diagnosis using Society of Critical Care Medicine (SCCM) Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) COVID-19 registry.
Methods: We performed a retrospective review of SCCM's VIRUS registry (NCT 04323787). Children under 18 years of age with oncological diagnosis and had COVID-19 infection were filtered and matched 1:4 with age group, sex, race, and ethnicity for control group without an oncological diagnosis. Demographic, clinical, and outcome variables were compared between oncology and control groups.
Results: A total of 45 children with history of cancer admitted with COVID-19 were included from 43 participating centers, a majority from the US. The control group had 180 children with COVID-19. Gender, age group distribution, race, ethnicity, and BMI categories were similar in oncology cases and controls. AST, ALT, and D-dimer levels were lower in oncology group compared to control (p< 0.05). WBC, ALC, ANC and ANC/lymphocyte ratio and other laboratory values were similar in both groups. Anticoagulation was used in a quarter of patients in both groups. More patients in oncology group were found to be on antifungal agents (13.3% vs 2.8%; OR 5.38 95% CI:1.56-18.54, p 0.03). Use of all other medications was similar in both groups. ICU admission rate (47.7% vs 51.7%) was similar in both groups. However, MIS-C diagnosis was significantly lower in oncology group compared to control group (p=0.0002). The proportion of children requiring mechanical ventilation (17.7% 11.1%) and the duration of mechanical ventilation were similar between two groups. Median (IQR) duration of ICU and hospital stay in oncology group were 4.89 [1.24-8.05] and 5.09 [2.63-8.75] days, respectively. ICU and hospital length of stays were similar in both groups. Hospital mortality was similar in both groups (6.7% vs 2.2%; p=0.13)
Conclusions: Disease severity, interventions, and outcomes in children with COVID-19 with and without oncological diagnoses are similar. The incidence of MIS-C is lower in oncology group.