COVID-19 infection in children with blood cancer: A systematic review

• Published in: Annals of hematology 2024-11
• Main Authors: Alhumaid, Saad, Al Noaim, Khalid, Almuslim, Anwar A, Turkistani, Jamela A, Alqurini, Zainab Sabri, Alshakhs, Abdullah Mohammed, Al Dossary, Nourah, Alabdulqader, Muneera, Majzoub, Rabab Abbas, Alnaim, Abdulrahman A, Alahmari, Abdulaziz A, Al Ghamdi, Mohammed A, Alabdulmohsen, Wafa, Alsharidah, Zakaria Ali, Alkhamees, Munther Saleh, AlAithan, Laith Abbas, Almurayhil, Abdulaziz Ahmed, Almurayhil, Yousuf Ahmed, Aljubran, Hassan Abdullah, Alhamdan, Zahra Salman, Shabib, Maitham Abdullah, Aldandan, Ali Wasel, Allowaim, Abduljaleel Ahmed, Al-Rasasi, Ali Younis, Albahrani, Ahlam Ayesh, Al Salem, Btol Ali, Bukhamseen, Mugdad Saleem, Al Ayeyd, Jinan Sadiq, Al Mutair, Abbas, Alhumaid, Hesham, Al Alawi, Zainab, Rabaan, Ali A
• Format: Article
• Language: English
• ISSN: 0939-5555; 1432-0584; 1432-0584
• DOI: 10.1007/s00277-024-06057-4

Blood cancer is the most common type of cancer and the leading cause of death by disease past infancy among children. Children with blood cancer are vulnerable population to viral infections such as coronavirus disease 2019 (COVID-19). To estimate the incidence of COVID-19 in children with blood cancer and analyse the demographic parameters, clinical characteristics and treatment outcomes in children with blood cancer with COVID-19 illness. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature for studies on the development of COVID-19 in children with blood cancer, published from December 1, 2019 to April 30, 2023, with English language restriction. Of the 3077 papers that were identified, 155 articles were included in the systematic review (83 case report, 54 cohort and 18 case-series studies). Studies involving 1289 children with blood cancer with confirmed COVID-19 were analysed. Leukaemias (1141 cases) were the most frequent types of blood cancer observed in children who developed COVID-19, followed by non-Hodgkin's lymphomas (59 cases), Hodgkin's lymphomas (36 cases), Langerhans cell histiocytosis (7 cases), myelodysplastic syndrome (7 cases) and myeloid neoplasm (1 case). Among all 1289 blood cancer paediatric cases who transmitted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), some children were documented to be admitted to the intensive care unit (ICU) (n = 175, 13.6%), intubated and placed on mechanical ventilation (MV) (n = 111, 8.6%), suffered acute respiratory distress syndrome (ARDS) (n = 144, 11.2%) or died (n = 111, 8.6%). Overall, COVID-19 in children with different types of blood cancer resulted in no or low severity of disease in 78.6% of all included cases (COVID-19 severity: asymptomatic = 238, mild = 601, or moderate = 171). Treatment for COVID-19 was not necessary in a small number of children with blood cancer (n = 94, 7.3%). Fatality in children with blood cancer with COVID-19 was reported in any of the included blood cancer categories for leukaemias (n = 99/1141, 8.7%), non-Hodgkin's lymphomas (n = 7/59, 11.9%), Hodgkin's lymphomas (n = 2/36, 5.5%), myelodysplastic syndrome (n = 1/7, 14.3%) or myeloid neoplasm (n = 1/1, 100%). Fatality rate in children with blood cancer infected with SARS-CoV-2 was the highest in patients with Hispanic ethnicity (n = 44/111, 39.6%) and COV