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Bandyopadhyay, Soham, Peter, Noel, Lakhoo, Kokila, Abib, Simone de Campos Vieira, Abdelhafeez, Hafeez, Wilson, Shaun, Pachl, Max, Martin, Benjamin, Nagras, Sonal, Sheth, Mihir et al (show 575 more authors) , Dominic, Catherine, Gandhi, Suraj, Parwani, Divya, Raj, Rhea, Munezero, Diella, Dutta, Rohini, Roseline, Nsimire Mulanga, McClafferty, Kellie, Nazari, Armin, Sriram, Smrithi, Pillarisetti, Sai, Nweze, King-David, Ashwinee, Aishwarya, Kalra, Gul, Patil, Poorvaprabha, Nathani, Priyansh, Bhullar, Khushman Kaur, Elhadi, Muhammed, Khan, Maryam, Rahim, Nehal, Madhusudanan, Shweta, Erhabor, Joshua, Shirke, Manasi, Mughal, Aishah, Au, Darica, Salehi, Mahan, Royyuru, Sravani, Ahmed, Mohamed, Hussain, Syeda Namayah Fatima, Robinson, Daniel, Casey, Anna, Khan, Mehdi, Dukundane, Alexandre, Festus, Kwizera, Govind, Vaishnavi, Pancharatnam, Rohan, Ochieng, Lorraine, Taylor, Elliott H, Nautiyal, Hritik, Crespo, Marta de Andres, Charuvila, Somy, Valetopoulou, Alexandra, Brar, Amanpreet, Zuberi, Hira, Ammouze, Imane, Ghosh, Dhruva, Peters, Nitin James, Bwala, Kefas John, Umar, AM, Aremu, Abdurahaman, Suleiman, Dauda E, Aliyu, Tybat, Saleem, Ayesha, Arshad, Muhammad, Turk, Kashaf, Altaf, Sadaf, Ogunsua, Oluseyi Oyebode, Sholadoye, Tunde Talib, Tolani, Musliu Adetola, Alfa, Yakubu, Musa, Keffi Mubarak, Irungu, Eric Mwangi, Muma, Ken, Muma, Sarah, Obat, Mitchelle, Badran, Youssef Sameh, Qasem, Abdulrahman Ghassan, Ayasra, Faris, Alnajjar, Reema, Abdel-Maboud, Mohamed, Bahaa, Abdelrahman, Saadeldin, Ayat M, Adwi, Mohamed, Adly, Mahmoud, Elshenawy, Abdallah, Harky, Amer 
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(2022)
Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic.
BMJ GLOBAL HEALTH, 7 (10).
e008797-.
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Abstract
<h4>Introduction</h4>Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality.<h4>Methods</h4>Prospective cohort study in 109 institutions in 41 countries.<h4>Inclusion criteria</h4>children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months.<h4>Results</h4>All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality.<h4>Conclusions</h4>Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer.
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