Association of Cancer Diagnosis and Therapeutic Stage With Mortality in Pediatric Patients With COVID-19, Prospective Multicenter Cohort Study From Latin America.

Autor:	Dominguez-Rojas JÁ; Pediatric Critical Care, Hospital Edgardo Rebagliati Martins, Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Lima, Peru., Vásquez-Hoyos P; Pediatric Critical Care, Hospital de San Jose, Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Bogota, Colombia.; Research Division, Department of Pediatrics, Fundacion Universitatia de Ciencias de la Salud-FUCS, Bogota, Colombia., Pérez-Morales R; Pediatric Critical Care, HOMI Fundacion Hospital Pediatrico La Misericordia, Bogota, Colombia., Monsalve-Quintero AM; Pediatric Critical Care, Fundación Valle del Lili, Cali, Colombia., Mora-Robles L; Pediatric Critical Care, Hospital SOLCA, Cuenca, Ecuador., Diaz-Diaz A; Pediatric Infectious Diseases, Hospital Pablo Tobon Uribe y Hospital General de Medellin, Medellin, Colombia., Torres SF; Pediatric Critical Care, Hospital Universitario Austral Pilar, Buenos Aires, Argentina., Castro-Dajer Á; Pediatric Oncology, Clinica Blas de Lezo, Cartagena, Colombia., Cabanillas-Burgos LY; Deparment of Pediatrics, Hospital Nacional Carlos Alberto Seguin Escobedo Essalud, Arequipa, Peru., Aguilera-Avendaño V; Pediatric Critical Care, Hospital del Niño Doctor Ovidio Aliaga Uría, La Paz, Bolivia., Cantillano-Quintero EM; Pediatric Critical Care, Hospital del Norte, San Pedro Sula, Honduras., Camporesi A; Department of Pediatric Anesthesia and Intensive Care, Vittore Buzzi Children's Hospital, Milano, Italy., Agulnik A; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States., Mukkada S; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States., Alvarado-Gamarra G; Pediatrics, Hospital Edgardo Rebagliati Martins, Lima, Peru.; Instituto de Investigación Nutricional, Lima, Perú., Rojas-Soto N; Hematóloga Pediatra, Hospital Edgardo Rebagliati Martins, Lima, Peru., Mendieta-Zevallos AL; Pediatric Emergency Department, Hospital Edgardo Rebagliati Martins, Lima, Peru., Tello-Pezo MV; Pediatric Oncology, Instituto Nacional de Salud del Niño, San Borja, Perú., Vásquez-Ponce L; Research Center 'Medicina de Precisión, ' Facultad de Medicina, Universidad de San Martín de Porres, Lima, Perú., Lasso-Palomino RE; Pediatric Critical Care, Fundación Valle del Lili, Cali, Colombia., Pérez-Arroyave MC; Pediatric Critical Care, Fundación Valle del Lili, Cali, Colombia., Trujillo-Honeysberg M; Pediatric Infectious Disease, Hospital Pablo Tobon Uribe, Medellín, Colombia., Mesa-Monsalve JG; Infectólogo Pediatra, Hospital General de Medellin, Medellin, Colombia., Pardo González CA; Hemato-oncólogo Pediatra, HOMI Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia., López Cubillos JF; Infectólogo Pediatra, HOMI Fundación Hospital Pediátrico La Misericordia, Bogota, Colombia., Gonzalez-Dambrauskas S; Specialized Pediatric Critical Care (CIPe), Casa de Galicia, Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Montevideo, Uruguay.; Medical School, Pediatric Critical Care, Pereira Rossell Medical Center (UCIN-CHPR), Universidad de la República, Montevideo, Uruguay., Coronado-Munoz A; Pediatric Critical Care Division, Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in pediatrics [Front Pediatr] 2022 May 03; Vol. 10, pp. 885633. Date of Electronic Publication: 2022 May 03 (Print Publication: 2022).
DOI:	10.3389/fped.2022.885633
Abstrakt:	Background: Children with cancer are at risk of critical disease and mortality from COVID-19 infection. In this study, we describe the clinical characteristics of pediatric patients with cancer and COVID-19 from multiple Latin American centers and risk factors associated with mortality in this population. Methods: This study is a multicenter, prospective cohort study conducted at 12 hospitals from 6 Latin American countries (Argentina, Bolivia, Colombia, Ecuador, Honduras and Peru) from April to November 2021. Patients younger than 14 years of age that had an oncological diagnosis and COVID-19 or multisystemic inflammatory syndrome in children (MIS-C) who were treated in the inpatient setting were included. The primary exposure was the diagnosis and treatment status, and the primary outcome was mortality. We defined "new diagnosis" as patients with no previous diagnosis of cancer, "established diagnosis" as patients with cancer and ongoing treatment and "relapse" as patients with cancer and ongoing treatment that had a prior cancer-free period. A frequentist analysis was performed including a multivariate logistic regression for mortality. Results: Two hundred and ten patients were included in the study; 30 (14%) died during the study period and 67% of patients who died were admitted to critical care. Demographics were similar in survivors and non-survivors. Patients with low weight for age (<-2SD) had higher mortality (28 vs. 3%, p = 0.019). There was statistically significant difference of mortality between patients with new diagnosis (36.7%), established diagnosis (1.4%) and relapse (60%), ( p <0.001). Most patients had hematological cancers (69%) and they had higher mortality (18%) compared to solid tumors (6%, p = 0.032). Patients with concomitant bacterial infections had higher mortality (40%, p = 0.001). MIS-C, respiratory distress, cardiovascular symptoms, altered mental status and acute kidney injury on admission were associated with higher mortality. Acidosis, hypoxemia, lymphocytosis, severe neutropenia, anemia and thrombocytopenia on admission were also associated with mortality. A multivariate logistic regression showed risk factors associated with mortality: concomitant bacterial infection OR 3 95%CI (1.1-8.5), respiratory symptoms OR 5.7 95%CI (1.7-19.4), cardiovascular OR 5.2 95%CI (1.2-14.2), new cancer diagnosis OR 12 95%CI (1.3-102) and relapse OR 25 95%CI (2.9-214). Conclusion: Our study shows that pediatric patients with new onset diagnosis of cancer and patients with relapse have higher odds of all-cause mortality in the setting of COVID-19. This information would help develop an early identification of patients with cancer and COVID-19 with higher risk of mortality. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Dominguez-Rojas, Vásquez-Hoyos, Pérez-Morales, Monsalve-Quintero, Mora-Robles, Diaz-Diaz, Torres, Castro-Dajer, Cabanillas-Burgos, Aguilera-Avendaño, Cantillano-Quintero, Camporesi, Agulnik, Mukkada, Alvarado-Gamarra, Rojas-Soto, Mendieta-Zevallos, Tello-Pezo, Vásquez-Ponce, Lasso-Palomino, Pérez-Arroyave, Trujillo-Honeysberg, Mesa-Monsalve, Pardo González, López Cubillos, Gonzalez-Dambrauskas and Coronado-Munoz.)
Databáze:	MEDLINE
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