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

Year 2022, Volume: 47 Issue: 1, 377 - 388, 31.03.2022

Utku Aygüneş , Barbaros Karagün , Hatice İlgen Şaşmaz , Tuğana Akbaş , Ali Bulent Antmen

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.

Keywords

kemoterapi, COVID-19, immünsüprese, pediatrik, hematoloji, onkoloji, SARS-CoV-2

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

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.

Keywords

Chemotherapy, COVID-19, immunocompromised, pediatric, hematology, oncology, Sars-CoV-2

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