|LETTER TO EDITOR
|Year : 2021 | Volume
| Issue : 3 | Page : 590-591
Low burden of COVID-19 disease in children with cancer and hematologic illnesses
Nemours Cardiac Center, A I duPont Hospital for Children, Wilmington, DE; Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
|Date of Submission||27-Jul-2021|
|Date of Decision||01-Aug-2021|
|Date of Acceptance||29-Aug-2021|
|Date of Web Publication||08-Oct-2021|
Nemours Cardiac Center, A I duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Thacker D. Low burden of COVID-19 disease in children with cancer and hematologic illnesses. Cancer Res Stat Treat 2021;4:590-1
I read the article titled, “Clinical profile and outcomes of COVID-19 infection during the first wave in children with hematological illnesses and cancer: An observational study from a tertiary care center in North India” by Bhayana et al. with great interest. The findings of the authors are consistent with what we have seen among pediatric patients across the world. Even as children constitute a rising percentage of new positive cases, most have mild disease. Nevertheless, one has to focus on minimizing the risk of the virus spreading within the hospital to other immunocompromised patients, while ensuring the best possible management of cases found positive for COVID-19. Studies have shown a delay in seeking care for malignancies during this pandemic, resulting in poor patient outcomes.,, Thus, while the authors highlight the low impact of COVID-19 disease itself on their patients, I am curious about the impact of delayed and modified treatments on long-term outcomes of the primary disease.
Second, I believe that further clarification is needed about some of the testing methods. The authors state, “Patients suspected to have COVID-19 infection without serological evidence were excluded from the study.” Serology typically refers to antibody tests, and I believe that antibody testing was only used for the one patient with multisystem inflammatory syndrome in children. In addition, the authors outline the protocol for repeat testing for inpatients and outpatients till the time of the negative test, with the median time from the onset of COVID-19 to a negative result of 21.3 days. Studies have shown that approximately 14% of patients test positive due to the persistence of viral RNA without the presence of infectious viral agents in the respiratory samples. The need for a negative test may have resulted in further unnecessary delays in treatment.
Another point of discussion is the role of vaccines in children. As vaccines become more widely available for the younger ages, conditions such as post-vaccine myocarditis with the mRNA vaccines have raised fresh concern for parents, leading to some vaccine hesitancy., The low burden of disease in the younger population, even in immunocompromised children, as highlighted by this study, raises the question of the need to vaccinate these children on a mass basis. Countries such as Germany and the United Kingdom have chosen to only vaccinate high risk children under 17 years of age. Instead, their focus is on vaccinating the older population and prevention of spread through social distancing and masking.
And lastly, my kudos to the authors on a well-thought out study with a clear message, providing much-needed reassurance to families and physicians caring for children with cancer and hematologic illnesses!
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Bhayana S, Kalra M, Sachdeva P, Sachdeva A. Clinical profile and outcomes of COVID-19 infection during the first wave in children with hematological illnesses and cancer: An observational study from a tertiary care center in North India. Cancer Res Stat Treat 2021;4:262-9. [Full text]
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