Novel coronavirus infection (COVID-19) in children with cancer

Abstract

The number of children with novel coronavirus infection (COVID-19) is small and their symptoms are milder than those of adults. Information on pediatric cancer patients with COVID-19 has remained limited. In this review, we summarize information on adult and pediatric cancer patients by focusing on overseas meta-analyses. The mortality rates of adult cancer patients with COVID-19 are reported to be 14–28% for solid tumors and 34% for hematological tumors, and advanced age, being male, and comorbidities are risk factors for severe COVID-19. In particular, the mortality rate has been reported to exceed 50% for patients under myelosuppression, and nosocomial infection should be carefully monitored. Although the prognosis of COVID-19 in children with cancer is better than that of adult cancer patients, treatment is often postponed or 4–10% of severe cases require ICU admission. Moreover, a mortality rate of 0–3% has been reported for patients under strong myelosuppression even in high-income countries. COVID-19 vaccines are widely used for adult cancer patients, but the seroconversion rates are lower in patients with hematological tumors (0.62) than in those with solid tumors (0.95) and in the general population. It is assumed that pediatric and young adult patients with cancers will become suitable candidates for active vaccination in the future. Health anxiety related to COVID-19 tends to be higher in childhood cancer survivors, especially with severe late effects, than in adult cancer survivors, so it is desirable to apply some distance-delivered care. At present, most of the clinical guidelines for childhood cancers are not based on sufficient evidence, but rather on the consensus recommendations of experts.