COVID-19 infection in children with underlying malignancies in Iran

• Published in: Journal of basic and clinical physiology and pharmacology Vol. 33; no. 1; p. 79
• Main Authors: Navaeian, Amene, Mahmoudi, Shima, Pourakbari, Babak, Bakhtiari, Maryam, Khodabandeh, Mahmoud, Abdolsalehi, Mohammad Reza, Sharari, Alieh Safari, Mamishi, Setareh
• Format: Journal Article
• Language: English
• Published: Germany 01-07-2021
• Subjects: Adolescent; Child; Child, Preschool; COVID-19 - epidemiology; Female; Humans; Infant; Iran - epidemiology; Male; Neoplasms - complications; Neoplasms - epidemiology; Pandemics; Iran; COVID-19; SARS-CoV-2; children; malignancies
• ISSN: 2191-0286

Although coronavirus disease 2019 (COVID-19) prognosis is mostly good in pediatric patients with no underlying diseases, there are a few reports on children with oncological underlying malignancies. This study aimed to describe the clinical and laboratory features of 20 children with COVID-19 who had underlying malignancies in an Iranian referral pediatrics hospital.
All children under 15-year-old of age with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive real-time polymerase chain reaction (PCR) and presence of an underlying malignancy were included in the study.
In this study, among 20 patients, 11 were male (55%). The mean age of the patients was 6.0 ± 4.1 years. Twelve patients (60%) had acute lymphocytic leukemia, two had acute myeloid leukemia (10%), and six had solid organ tumors (30%). The most common symptoms were fever (65%) and cough (65%). We reported severe pneumonia in seven hospitalized patients (35%) and three patients (20%) required intensive care unit admission and mechanical ventilation. Procalcitonin was normal in 73% of the cases (11 out of 15), but it was highly elevated in four cases (27%). Five patients (25%) had positive blood cultures and a mortality of 20% was reported.
This is the largest study on SARS-CoV-2 infected pediatric patients with underlying malignancies in Iran. Since the risk of exposure to SARS-CoV-2 and even death in children with malignancy, either in the hospital or community setting during the pandemic is high, special precautions to reduce the risk of transmission are highly suggested.