COVID-19 in Children with Cancer: A Retrospective Study
,
Abstract
Background: The emerging COVID-19 is less common in children than adults and has fewer symptoms. However, there are more concerns about the severity of symptoms in patients’ kids undergoing chemotherapy. Objective: This study aimed to investigate COVID-19 infection in pediatric cancer patients.
Methods: This was a retrospective study of 302 patients with COVID-19 infection confirmed by RT-PCR test and aged ≤18, referred to a multi-specialized pediatric hospital, Ahvaz-Iran, from 2020-2021. Children were divided into two groups: malignant (n = 31) and non-malignant (n = 271).
Results: The median age of the patient was 7 years. 73.7 % of the patients were male. The most common symptom was cough (47.36%). On admission, leucopenia was recorded in 63.15% of malignancy patients. The Outcomes death was %0.7 and %3.2 in the malignancy and Controls groups, respectively. There was a statistically significant reduction between the malignancy and Controls group (P=0.02). Also, in terms of myalgia, the group of children with malignancy showed a lower percentage than the control group or non-cancerous children (P=0.04). Laboratory data showed that leukopenia, CRP, and ferritin levels caused by COVID-19 disease in children with malignancy were not significantly different from healthy children (p> 0.05).
Conclusion: COVID-19 mortality in children with malignancy is significantly lower than in non-cancerous children. Further studies are needed to understand the course of COVID-19 infection in children with cancer.
1. Fendler, Annika, et al. COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety. Nature Reviews Clinical Oncology, 2022, 19.6: 385-401.
2. Mazidimoradi A, Hadavandsiri F, Momenimovahed Z, Salehiniya H. Impact of the COVID-19 Pandemic on Colorectal Cancer Diagnosis and Treatment: a Systematic Review. J Gastrointest Cancer. 2021: 29:1–17.
3. Arpali E, Akyollu B, Yelken B, Tekin S, Turkmen A, Kocak B. Case report: A kidney transplant patient with mild COVID-19. Transpl Infect Dis. 2020; 22(4):0–1.
4. YANG, Ludi, et al. Effects of cancer on patients with COVID-19: a systematic review and meta-analysis of 63,019 participants. Cancer Biology & Medicine, 2021, 18.1: 298-307.
5. Hrusak O, Kalina T, Wolf J, Balduzzi A, Provenzi M, Rizzari C, et al. Flash survey on severe acute respiratory syndrome COVID-19-2 infections in paediatric patients on anticancer treatment. Eur J Cancer. 2020; 132: 11–6.
6. Liu K, Zhang W, Yang Y, Zhang J, Li Y, Chen Y. Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Complement Ther Clin Pract. 2020 May; 39:101166.
7. Avanzato VA, Matson MJ, Seifert SN, Pryce R, Williamson BN, Anzick SL, et al. Case Study: Prolonged infectious SARS-CoV-2 shedding from an asymptomatic immunocompromised cancer patient. Cell [Internet]. 2020; 1–12
8.Tian Y, Qiu X, Wang C, Zhao J, Jiang X, Niu W, et al. Cancer associates with risk and severe events of COVID-19: A systematic review and meta-analysis. Int J Cancer. 2020; (June 2020): 363–74.
9. Stokes CL, Patel PA, Sabnis HS, Mitchell SG, Yildirim IB, Pauly MG. Severe COVID-19 disease in two pediatric oncology patients. Pediatr Blood Cancer. 2020; 67(9): 2–5
10. Bellino S, Punzo O, Rota MC, Del Manso M, Urdiales AM, Andrianou X, et al. COVID-19 Disease Severity Risk Factors for Pediatric Patients in Italy. Pediatrics. 2020; 146 (4(.
11. Montoya J, Ugaz C, Alarcon S, Maradiegue E, García J, Díaz R, et al. COVID-19 in pediatric cancer patients in a resource-limited setting: National data from Peru. Pediatr Blood Cancer. 2020; 7(July):1–2
12. Fraid Boulad, Mini Kamboj, Nancy Bouvie, Audrey Mauguen, Andrew L. Kung. COVID-19 in chidren With Cancer in New York City. Jama Oncology, May 13.2020.10.1001.
13. Lima ALMA, Borborema MCD, Matos APR, Oliveira KMM, Mello MJG, Lins MM. COVID-19 cohort on children with cancer: delay in treatment and increased frequency of deaths. Rev Bras Saúde Matern Infant. 2021; 21(suppl 1):299–304.
14. Węclawek-Tompol, J., Zakrzewska, Z., Gryniewicz-Kwiatkowska, O. et al. COVID-19 in pediatric cancer patients is associated with treatment interruptions but not with short-term mortality: a Polish national study. J Hematol Oncol 14, 163 (2021).
15. Dorantes-Acosta Elisa, Ávila-Montiel Diana, Klünder-Klünder Miguel, Juárez-Villegas Luis, Márquez-González Horacio. Survival and Complications in Pediatric Patients With Cancer and COVID-19: A Meta-Analysis. Frontiers in Oncology. 10. 2021.3103.
16. Chiaravalli S, Ferrari A, Sironi G, Gattuso G, Bergamaschi L, Puma N, et al. A collateral effect of the COVID-19‐19 pandemic: delayed diagnosis in pediatric solid tumors. Pediatr Blood Cancer. 2020; 67(10): e28640.
17. O’Neill AF, Wall CB, Roy‐Bornstein C, Diller L. Timely pediatric cancer diagnoses: an unexpected casualty of the COVID-19‐19 surge. Pediatr Blood Cancer. 2020;67(12):e28729.
18. Graetz D, Agulnik A, Ranadive R, Vedaraju Y, Chen Y, Chantada G, et al. Global effect of the COVID-19 pandemic on pediatric cancer care: a cross-sectional study. Lancet Child Adolesc Heal. 2021;5(5): 332–40.
19. beid FSE, Ragab IA, Elsherif NHK, Makkeyah S, Mostafa S, Eltonbary K, Matbouly S, Mostafa A, Goma H, Agwa SH, Hafez HM, Girgis S, El Gendy YG, El-Sayed MH. COVID-19 in Children with Cancer: A Single Low-Middle Income Center Experience. J Pediatr Hematol Oncol. 2021 Nov 1;43(8):e1077-e1081.
20. Meena JP, Kumar Gupta A, Tanwar P, Ram Jat K, Mohan Pandey R, Seth R. Clinical presentations and outcomes of children with cancer and COVID-19: A systematic review. Pediatr Blood Cancer. 2021 Jun; 68(6): e29005.
21. Azim Mehrvar, Ibrahim Qaddoumi, Maryam Tashvighi, Ali Naderi, Hadi Mousakhani, Ramin Alasvand, Babak Shekarchi, Negar Afsar, Mahyar Nourian, Narjes Mehrvar, Treatment and outcomes of pediatric patients with cancer and COVID-19 at MAHAK pediatric cancer treatment and research center, Tehran, Iran, Seminars in Oncology, 48, 4–6,2021:295-303.
22. Raber-Durlacher JE, Epstein JB, Raber J, van Dissel JT, van Winkelhoff AJ, Guiot HF, van der Velden U. Periodontal infection in patients treated with high-dose chemotherapy. Support Care Cancer 2002; 10:466-73.
23. Chighizola, C., Ong, V. H., & Denton, C. P. Cyclophosphamide as disease-modifying therapy for scleroderma: pros and cons. International Journal of Clinical Rheumatology, 2011. 6(2), 219-230.
24. Hiam-Galvez, K.J., Allen, B.M. & Spitzer, M.H. Systemic immunity in cancer. Nat Rev Cancer 21, 345–359 (2021).
25. Hojyo S, Uchida M, Tanaka K, et al. How COVID-19 induces cytokine storm with high mortality. Inflamm Regen. 2020;40:37. Published 2020 Oct 1.
26. Santegoets, S. J. et al. Myeloid derived suppressor and dendritic cell subsets are related to clinical outcome in prostate cancer patients treated with prostate GVAX and ipilimumab. J. Immunother. Cancer 2, 31 (2014).
27. Berraondo, P., Sanmamed, M.F., Ochoa, M.C. et al. Cytokines in clinical cancer immunotherapy. Br J Cancer 120, 6–15 (2019).
28. Schultze JL, Aschenbrenner AC. COVID-19 and the human innate immune system. Cell. 2021;184(7):1671-1692.
29. Organization, W.H. 2019 (COVID-19). Situation Report . COVID-19 disease (COVID-19-2019) situation reports. 2022.
2. Mazidimoradi A, Hadavandsiri F, Momenimovahed Z, Salehiniya H. Impact of the COVID-19 Pandemic on Colorectal Cancer Diagnosis and Treatment: a Systematic Review. J Gastrointest Cancer. 2021: 29:1–17.
3. Arpali E, Akyollu B, Yelken B, Tekin S, Turkmen A, Kocak B. Case report: A kidney transplant patient with mild COVID-19. Transpl Infect Dis. 2020; 22(4):0–1.
4. YANG, Ludi, et al. Effects of cancer on patients with COVID-19: a systematic review and meta-analysis of 63,019 participants. Cancer Biology & Medicine, 2021, 18.1: 298-307.
5. Hrusak O, Kalina T, Wolf J, Balduzzi A, Provenzi M, Rizzari C, et al. Flash survey on severe acute respiratory syndrome COVID-19-2 infections in paediatric patients on anticancer treatment. Eur J Cancer. 2020; 132: 11–6.
6. Liu K, Zhang W, Yang Y, Zhang J, Li Y, Chen Y. Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Complement Ther Clin Pract. 2020 May; 39:101166.
7. Avanzato VA, Matson MJ, Seifert SN, Pryce R, Williamson BN, Anzick SL, et al. Case Study: Prolonged infectious SARS-CoV-2 shedding from an asymptomatic immunocompromised cancer patient. Cell [Internet]. 2020; 1–12
8.Tian Y, Qiu X, Wang C, Zhao J, Jiang X, Niu W, et al. Cancer associates with risk and severe events of COVID-19: A systematic review and meta-analysis. Int J Cancer. 2020; (June 2020): 363–74.
9. Stokes CL, Patel PA, Sabnis HS, Mitchell SG, Yildirim IB, Pauly MG. Severe COVID-19 disease in two pediatric oncology patients. Pediatr Blood Cancer. 2020; 67(9): 2–5
10. Bellino S, Punzo O, Rota MC, Del Manso M, Urdiales AM, Andrianou X, et al. COVID-19 Disease Severity Risk Factors for Pediatric Patients in Italy. Pediatrics. 2020; 146 (4(.
11. Montoya J, Ugaz C, Alarcon S, Maradiegue E, García J, Díaz R, et al. COVID-19 in pediatric cancer patients in a resource-limited setting: National data from Peru. Pediatr Blood Cancer. 2020; 7(July):1–2
12. Fraid Boulad, Mini Kamboj, Nancy Bouvie, Audrey Mauguen, Andrew L. Kung. COVID-19 in chidren With Cancer in New York City. Jama Oncology, May 13.2020.10.1001.
13. Lima ALMA, Borborema MCD, Matos APR, Oliveira KMM, Mello MJG, Lins MM. COVID-19 cohort on children with cancer: delay in treatment and increased frequency of deaths. Rev Bras Saúde Matern Infant. 2021; 21(suppl 1):299–304.
14. Węclawek-Tompol, J., Zakrzewska, Z., Gryniewicz-Kwiatkowska, O. et al. COVID-19 in pediatric cancer patients is associated with treatment interruptions but not with short-term mortality: a Polish national study. J Hematol Oncol 14, 163 (2021).
15. Dorantes-Acosta Elisa, Ávila-Montiel Diana, Klünder-Klünder Miguel, Juárez-Villegas Luis, Márquez-González Horacio. Survival and Complications in Pediatric Patients With Cancer and COVID-19: A Meta-Analysis. Frontiers in Oncology. 10. 2021.3103.
16. Chiaravalli S, Ferrari A, Sironi G, Gattuso G, Bergamaschi L, Puma N, et al. A collateral effect of the COVID-19‐19 pandemic: delayed diagnosis in pediatric solid tumors. Pediatr Blood Cancer. 2020; 67(10): e28640.
17. O’Neill AF, Wall CB, Roy‐Bornstein C, Diller L. Timely pediatric cancer diagnoses: an unexpected casualty of the COVID-19‐19 surge. Pediatr Blood Cancer. 2020;67(12):e28729.
18. Graetz D, Agulnik A, Ranadive R, Vedaraju Y, Chen Y, Chantada G, et al. Global effect of the COVID-19 pandemic on pediatric cancer care: a cross-sectional study. Lancet Child Adolesc Heal. 2021;5(5): 332–40.
19. beid FSE, Ragab IA, Elsherif NHK, Makkeyah S, Mostafa S, Eltonbary K, Matbouly S, Mostafa A, Goma H, Agwa SH, Hafez HM, Girgis S, El Gendy YG, El-Sayed MH. COVID-19 in Children with Cancer: A Single Low-Middle Income Center Experience. J Pediatr Hematol Oncol. 2021 Nov 1;43(8):e1077-e1081.
20. Meena JP, Kumar Gupta A, Tanwar P, Ram Jat K, Mohan Pandey R, Seth R. Clinical presentations and outcomes of children with cancer and COVID-19: A systematic review. Pediatr Blood Cancer. 2021 Jun; 68(6): e29005.
21. Azim Mehrvar, Ibrahim Qaddoumi, Maryam Tashvighi, Ali Naderi, Hadi Mousakhani, Ramin Alasvand, Babak Shekarchi, Negar Afsar, Mahyar Nourian, Narjes Mehrvar, Treatment and outcomes of pediatric patients with cancer and COVID-19 at MAHAK pediatric cancer treatment and research center, Tehran, Iran, Seminars in Oncology, 48, 4–6,2021:295-303.
22. Raber-Durlacher JE, Epstein JB, Raber J, van Dissel JT, van Winkelhoff AJ, Guiot HF, van der Velden U. Periodontal infection in patients treated with high-dose chemotherapy. Support Care Cancer 2002; 10:466-73.
23. Chighizola, C., Ong, V. H., & Denton, C. P. Cyclophosphamide as disease-modifying therapy for scleroderma: pros and cons. International Journal of Clinical Rheumatology, 2011. 6(2), 219-230.
24. Hiam-Galvez, K.J., Allen, B.M. & Spitzer, M.H. Systemic immunity in cancer. Nat Rev Cancer 21, 345–359 (2021).
25. Hojyo S, Uchida M, Tanaka K, et al. How COVID-19 induces cytokine storm with high mortality. Inflamm Regen. 2020;40:37. Published 2020 Oct 1.
26. Santegoets, S. J. et al. Myeloid derived suppressor and dendritic cell subsets are related to clinical outcome in prostate cancer patients treated with prostate GVAX and ipilimumab. J. Immunother. Cancer 2, 31 (2014).
27. Berraondo, P., Sanmamed, M.F., Ochoa, M.C. et al. Cytokines in clinical cancer immunotherapy. Br J Cancer 120, 6–15 (2019).
28. Schultze JL, Aschenbrenner AC. COVID-19 and the human innate immune system. Cell. 2021;184(7):1671-1692.
29. Organization, W.H. 2019 (COVID-19). Situation Report . COVID-19 disease (COVID-19-2019) situation reports. 2022.
| Files | ||
| Issue | Vol 9, No 2 (2026) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/igj.v9i2.22046 | |
| Keywords | ||
| Cancer Children COVID-19 Malignancy Mortality | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Albooativi K, Hematian F, Jaseb K, Kouti L, Mirkarimi M. COVID-19 in Children with Cancer: A Retrospective Study. Immunol Genet J. 2026;9(2):50-56.
