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Pediatrik hematoloji-onkoloji ve nakil hastalarında COVID-19 enfeksiyonunun klinik ve radyolojik özellikleri

Year 2022, Volume: 47 Issue: 1, 377 - 388, 31.03.2022
https://doi.org/10.17826/cumj.1036774

Abstract

Amaç: Bu çalışmanın amacı, COVID-19'un bu demografideki özelliklerini, pandemi sırasında pediatrik kanser hastalarının özelliklerini ve malign hastalık tedavisine yaklaşımı ortaya koymaktır.
Gereç ve Yöntem: COVID-19 tanısı alan on beş pediatrik hematoloji onkoloji hastası geriye dönük olarak incelendi. Sars-CoV-2 testi pozitif çıkan 18 yaş altı 15 hastayla ilgili klinik, laboratuvar ve radyolojik veriler toplandı.
Bulgular: Pediyatrik hematoloji onkoloji poliklinik ve servisinde takip edilen, COVID-19 için test edilen 12117 hastadan 1125’i semptomatik olup 14'ü pozitifti. Bir vakaya klinik ve radyolojik özellikleri ile COVID-19 tanısı konuldu. Vakaların çoğunda hafif hastalık bulguları vardı. Toplam on çocuk yatarak tedavi alırken, beş hastaya oksijen desteği gerekti. Üç hastaya mekanik ventilasyon ile solunum desteği gerekti ve sonra kaybedildi. Yoğun kemoterapi ve/veya immünosupresif tedavi alan hastalarda gerçek zamanlı polimeraz zincir reaksiyonu (RT-PCR) pozitiflik süresinin uzadığı görüldü. 15 (%100) Sars-CoV-2 pozitif hastanın tümünde hastaların kemoterapisi ertelendi. Çocukların göğüs bilgisayarlı tomografi (CT) görüntülemelerinde görülen değişiklikler yetişkinlere göre esas olarak daha hafif olmasına rağmen, yoğun kanser tedavisi gören hastalarda radyolojik bulgular nispeten daha şiddetliydi.
Sonuç: Kanser tedavisi görmüş veya kök hücre nakli yapılmış çocuklar ciddi COVID-19 riski altında olabilir ve sürekli izlenmelidir.

References

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  • Dayal D. We urgently need guidelines for managing COVID-19 in children with comorbidities. Acta Paediatr. 2020;109:1497-8.
  • Chen Z, Xiong H, Li JX, Li H, Tao F, Yang YT et al. COVID-19 with post-chemotherapy agranulocytosis in childhood acute leukemia: a case report. Zhonghua Xue Ye Xue Za Zhi. 2020;41:341-3.
  • Bouffet E, Challinor J, Sullivan M, Biondi A, Rodriguez-Galindo C, Pritchard-Jones K. Early advice on managing children with cancer during the COVID‐19 pandemic and a call for sharing experiences. Pediatr Blood Cancer. 2020;67:e28327.
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  • He W, Chen L, Chen L, Yuan G, Fang Y, Chen W et al. COVID-19 in persons with haematological cancers. Leukemia. 2020;34:1637-45.
  • Kuderer NM, Choueiri TK, Shah DP, Shyr Y, Rubinstein SM, Rivera DR et al. COVID-19 and Cancer Consortium. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020;395:1907-18.
  • Faura A, Rives S, Lassaletta Á, Sebastián E, Madero L, Huerta J et al. Initial report on Spanish pediatric oncologic, hematologic, and post stem cell transplantation patients during SARS-CoV-2 pandemic. Pediatr Blood Cancer. 2020;67:e28557.
  • Vicent MG, Martinez AP, Trabazo Del Castillo M, Molina B, Sisini L, Morón-Cazalilla G et al. COVID-19 in pediatric hematopoietic stem cell transplantation: The experience of Spanish Group of Transplant (GETMON/GETH). Pediatr Blood Cancer. 2020;67:e28514.
  • Mehra MR, Desai SS, Kuy S, Henry TD, Patel AN. Cardiovascular disease, drug therapy, and mortality in covid-19. N Engl J Med. 2020;382:e102.
  • Cento V, Colagrossi L, Nava A, Lamberti A, Senatore S, Travi G et al. Persistent positivity and fluctuations of SARS-CoV-2 RNA in clinically-recovered COVID-19 patients. J Infect. 2020;81:e90-e92.
  • Yun H, Sun Z, Wu J, Tang A, Hu M, Xiang Z. Laboratory data analysis of novel coronavirus (COVID-19) screening in 2510 patients. Clin Chim Acta. 2020;507:94-7.
  • Aguirre Pascual E, Coca Robinot D, Gallego Herrero C, Navallas Irujo M, Rasero Ponferrada M, Pont Vilalta M. Pediatric chest X-rays during the COVID-19 pandemic. Radiologia (Engl Ed). 2021;63:106-14.

Clinical and radiological features of COVID-19 infection in pediatric hematology-oncology and transplant patients

Year 2022, Volume: 47 Issue: 1, 377 - 388, 31.03.2022
https://doi.org/10.17826/cumj.1036774

Abstract

Purpose: The goal of this study is to explain the characteristics of COVID-19 in this demographic, as well as the impact it had on pediatric cancer care during the pandemic.
Materials and Methods: Fifteen COVID-19 patients diagnosed were studied retrospectively. Clinical, laboratory and radiological data were collected in relation to 15 patients under the age of 18 who tested positive for Sars-CoV-2.
Results: Of the 12117 pediatric hemato-oncological patients tested for COVID-19, 1125 patients showed symptoms, and 14 tested positive. The majority of cases suffered minor illnesses. A total of ten children required inpatient care, five needed oxygen support, and four required mechanical ventilation and later died. It was noted that the duration of real-time polymerase chain reaction (RT-PCR) positivity was prolonged in patients receiving intensive chemotherapy and/or immunosuppressive therapy. Patients’ chemotherapy was delayed in all 15 (100%) Sars-CoV-2-positive patients. Although changes visible on chest computed tomography (CT) imaging of children were mainly milder than in adults, radiological findings were more severe in patients who received relatively intensive cancer treatment.
Conclusion: Children who have been treated for cancer or who have undergone a hematopoietic stem cell transplantation (HSCT) may be at greater risk of severe COVID-19 and should be under constant observation.

References

  • Alp EE, Dalgic N, Yilmaz V, Altuntas Y, Ozdemir HM. Evaluation of patients with suspicion of covıd-19 in pediatric emergency department. Med Bull Sisli Etfal Hosp. 2021;55:179-87
  • World Health Organization. Coronavirus Disease (COVID-19) Pandemic. Geneva, WHO, 2020.
  • Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020;145:e20200702.
  • Çokuğraş H, Önal P. SARS-CoV-2 infection in children. Turk Pediatr Ars. 2020;55:95-102.
  • Evliyaoğlu O. Children with chronic disease and COVID-19. Turk Pediatr Ars. 2020;55:93-4.
  • Hijano DR, Maron G, Hayden RT. Respiratory viral infections in patients with cancer or undergoing hematopoietic cell transplant. Front Microbiol. 2018;9:3097.
  • Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109:1088-95.
  • Dayal D. We urgently need guidelines for managing COVID-19 in children with comorbidities. Acta Paediatr. 2020;109:1497-8.
  • Chen Z, Xiong H, Li JX, Li H, Tao F, Yang YT et al. COVID-19 with post-chemotherapy agranulocytosis in childhood acute leukemia: a case report. Zhonghua Xue Ye Xue Za Zhi. 2020;41:341-3.
  • Bouffet E, Challinor J, Sullivan M, Biondi A, Rodriguez-Galindo C, Pritchard-Jones K. Early advice on managing children with cancer during the COVID‐19 pandemic and a call for sharing experiences. Pediatr Blood Cancer. 2020;67:e28327.
  • Yazal Erdem A, Yasar Özbek N. SARS COV-2 Infection in children with leukemia. Turkish J Pediatr Dis. 2020;14(suppl):41-7.
  • Li YY, Wang WN, Lei Y, Zhang B, Yang J, Hu JW et al. Comparison of the clinical characteristics between RNA positive and negative patients clinically diagnosed with 2019 novel coronavirus pneumonia. Zhonghua Jie He He Hu Xi Za Zhi. 2020;43:E023.
  • Liu R, Han H, Liu F, Lv Z, Wu K, Liu Y et al. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. Clin Chim Acta. 2020;505:172-5.
  • Liu J, Yu H, Zhang S. The indispensable role of chest CT in the detection of coronavirus disease 2019 (COVID-19). Eur J Nucl Med Mol Imaging. 2020;47:1638-9.
  • Turkish Ministry of Health. COVID-19 (SARS-CoV-2 Infection) Guide-Study of Scientific Board Turkish Ministry of Health. Ankara, Turkish Ministry of Health, 2020.
  • de Rojas T, Pérez-Martínez A, Cela E, Baragaño M, Galán V, Mata C et al. COVID‐19 infection in children and adolescents with cancer in Madrid. Pediatr Blood Cancer. 2020;67:e28397.
  • Rouger-Gaudichon J, Thébault E, Félix A, Phulpin A, Paillard C, Alimi A et al. Impact of the first wave of COVID-19 on pediatric oncology and hematology: A report from the French Society of Pediatric Oncology. Cancers (Basel). 2020;12:3398.
  • Duan Y ni, Zhu Y qiu, Tang L lei, Qin J. CT features of novel coronavirus pneumonia (COVID-19) in children. Eur Radiol. 2020;30:4427-33.
  • Wang SM, Tao F, Hou Y, Zhang A, Xiong H, Sun JJ et al. Screening of SARS-CoV-2 in 299 hospitalized children with hemato-oncological diseases: a multicenter survey in Hubei, China. Curr Med Sci. 2020;40:642-5.
  • Romeih M, Mahrous MR, Shalby L, Khedr R, Soliman S, Hassan R et al. Prognostic impact of CT severity score in childhood cancer with SARS-CoV-2. Egypt J Radiol Nuel Med. 2021;52.:200.
  • Chen ZH, Li YJ, Wang XJ, Ye YF, Wu BL, Zhang Y et al. Chest CT of COVID-19 in patients with a negative first RT-PCR test. Medicine (Baltimore). 2020;99:e20837.
  • Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020;55:1169-74.
  • Gampel B, Troullioud Lucas AG, Broglie L, Gartrell-Corrado RD, Lee MT, Levine J et al. COVID‐19 disease in New York City pediatric hematology and oncology patients. Pediatr Blood Cancer. 2020;67:e28420.
  • André N, Rouger-Gaudichon J, Brethon B, Phulpin A, Thébault É, Pertuisel S et al. COVID-19 in pediatric oncology from French pediatric oncology and hematology centers: High risk of severe forms? Pediatr Blood Cancer. 2020;67:e28392.
  • He W, Chen L, Chen L, Yuan G, Fang Y, Chen W et al. COVID-19 in persons with haematological cancers. Leukemia. 2020;34:1637-45.
  • Kuderer NM, Choueiri TK, Shah DP, Shyr Y, Rubinstein SM, Rivera DR et al. COVID-19 and Cancer Consortium. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020;395:1907-18.
  • Faura A, Rives S, Lassaletta Á, Sebastián E, Madero L, Huerta J et al. Initial report on Spanish pediatric oncologic, hematologic, and post stem cell transplantation patients during SARS-CoV-2 pandemic. Pediatr Blood Cancer. 2020;67:e28557.
  • Vicent MG, Martinez AP, Trabazo Del Castillo M, Molina B, Sisini L, Morón-Cazalilla G et al. COVID-19 in pediatric hematopoietic stem cell transplantation: The experience of Spanish Group of Transplant (GETMON/GETH). Pediatr Blood Cancer. 2020;67:e28514.
  • Mehra MR, Desai SS, Kuy S, Henry TD, Patel AN. Cardiovascular disease, drug therapy, and mortality in covid-19. N Engl J Med. 2020;382:e102.
  • Cento V, Colagrossi L, Nava A, Lamberti A, Senatore S, Travi G et al. Persistent positivity and fluctuations of SARS-CoV-2 RNA in clinically-recovered COVID-19 patients. J Infect. 2020;81:e90-e92.
  • Yun H, Sun Z, Wu J, Tang A, Hu M, Xiang Z. Laboratory data analysis of novel coronavirus (COVID-19) screening in 2510 patients. Clin Chim Acta. 2020;507:94-7.
  • Aguirre Pascual E, Coca Robinot D, Gallego Herrero C, Navallas Irujo M, Rasero Ponferrada M, Pont Vilalta M. Pediatric chest X-rays during the COVID-19 pandemic. Radiologia (Engl Ed). 2021;63:106-14.
There are 32 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research
Authors

Utku Aygüneş 0000-0001-9903-2923

Barbaros Karagün 0000-0002-7678-5524

Hatice İlgen Şaşmaz 0000-0001-9361-9838

Tuğana Akbaş 0000-0002-6869-2467

Ali Bulent Antmen 0000-0001-6058-6021

Publication Date March 31, 2022
Acceptance Date February 4, 2022
Published in Issue Year 2022 Volume: 47 Issue: 1

Cite

MLA Aygüneş, Utku et al. “Clinical and Radiological Features of COVID-19 Infection in Pediatric Hematology-Oncology and Transplant Patients”. Cukurova Medical Journal, vol. 47, no. 1, 2022, pp. 377-88, doi:10.17826/cumj.1036774.