The Impact of COVID-19 on Pediatric Cancer Patients
Support in Uncertain Times
While the Omicron variant has dominated COVID-19 coverage in the news for the past several months, there is not enough verified research on the impact it has had on children with cancer. Doctors are continuing to collect data and analyze the findings. COVID cases in children worldwide were studied during the first year of the pandemic revealing evidence about the impact on young cancer patients. A global research study published by the Lancet medical journal in the summer of 2021 and partially funded by the National Cancer Institute through the National Institutes of Health shed light on how the COVID-19 affected children with cancer.
Global Registry of Covid 19 in Childhood Cancer
The medical staff at St. Jude Children’s Research Hospital and the International Society of Pediatric Oncology (SIOP) conducted the study. One accomplishment was the creation of the Global Registry of COVID-19 in Childhood Cancer to track how the pandemic has impacted pediatric cancer patients. Between April 2020 and February 2021, researchers looked at 1,500 children under age 19 from over 45 countries. The research found that 20% of pediatric cancer patients developed severe infections that often required hospitalization. By comparison, 1 to 6% of children without cancer developed severe infections during this same period. Furthermore, hospitalization occurred in 65% of cancer patients who developed the infections, and unfortunately, 4% of these young patients died due to COVID-19.
The study concluded that children with cancer fare worse with COVID-19 than children without cancer. This conclusion may be an obvious summation, but the research’s importance was to take these findings and use the medical evidence to help make critical decisions to aid and prevent the virus from spreading in young cancer patients. The work of the researchers continues as they invite health care professionals worldwide to voluntarily report any patients with malignancy or prior hematopoietic stem cell transplant under the age of 19 at the time of a laboratory-confirmed SARS-CoV-2 infection. To learn more, visit the COVID-19 and Childhood Cancer Registry | St. Jude Global (stjude.org).
Ripple Effect of Pandemic on Cancer Treatment and Diagnosis
Research from St. Jude and SIOP also determined that cancer treatment was altered in those children who developed severe infections. Doctors modified cancer care in 56% of patients, with chemotherapy withheld in 45% of cases during Covid treatment. In the first year of the pandemic, other factors disrupted access to health care in some regions of the country.
A September 2020 article in Pediatric Blood & Cancer, a journal funded by the American Society of Pediatric Hematology/Oncology (ASPHO), uncovered disparities in the level of care provided to children when examining data on young patients in the Boston area. The discrepancies occurred despite the American Academy of Pediatrics and the Center for Disease Control (CDC) recommendations that in-person doctor visits and childhood vaccinations continue. Some primary care clinics reduced hours during the pandemic, offered only virtual visits, or in some cases had limited resources and staff.
Also, some parents were apprehensive about leaving their homes during the quarantine to go into doctor’s offices or medical centers and possibly be exposed to the virus. The ASPHO report uncovered the possibility that some pediatric cancer diagnoses may have been missed due to these factors during the first months of the pandemic. The researchers compared the March to May periods in 2019 versus 2020 and found a 56% decline in cancer diagnosis. The rise of COVID-19 did not cause cancer rates to go down, but issues with adequate healthcare may have played a role.
As of early February, there is some encouraging news that the overall number of Covid cases is declining, and hospitalization and death rates continue to go down. Covid continues to be a mild annoyance to the general population of Americans; mask mandates, supply chain issues impacting daily life, and longing for the days when things were “normal.” But what impact has COVID-19 had on one of our more vulnerable segments of society, pediatric cancer patients?
Addressing Critical Issues for Young Cancer Patients as Pandemic Rages Forward
As the COVID-19 pandemic moves into its third year, some uncertainties remain, especially as new variants emerge. But needs of young cancer patients are being met. The US Food & Drug Administration (FDA) focuses on issues faced by many cancer patients through their Oncology Center for Excellence (OCE). During these extended periods of supply chain issues where there are shortages in everything from lumber to cream cheese, the FDA focuses on preventing drug shortages. The “FDA is proactively monitoring the supply chain, and OCE will work closely with the Center for Drug Evaluation and Research to prevent or mitigate shortages of oncology drugs that are critical to the treatment of patients with cancer.”
In the past year, one crucial factor that has helped limit the number of hospitalization and deaths as the number of cases grows is the access to the Covid vaccines. Since vaccine approval in mid-2021, the CDC has provided valuable recommendations for young people under 19 years. And this information is most important for those who are moderately or severely immunocompromised. Cancer patients are among those who fall into this segment. The CDC recommends vaccinations and a booster dose, especially for patients undergoing chemotherapy due to weakened immune systems and increased chance of infections.
Current situation with Covid 19
According to the Centers for Disease Control (CDC), as of February 1, 2022, nearly 75 million Americans have gotten some variation of the SARS-CoV-2 (COVID-19) virus, a staggering number that seems almost unreal, especially given that 1/3 of those cases have occurred in just the past three months. Since the vaccines became widely available to most Americans in the Spring and Summer of 2021, the impact of the virus for most is less severe, even more so with a booster dose. Many people who test positive are surprised to learn they have the virus because they don’t “feel sick.” The vaccines do help to suppress the severity of the virus. The CDC also reports that unvaccinated adults have five times the risk of infection and more than 50 times the risk of COVID-19-associated death.
Currently, the CDC recommends everyone over the age of 5 get the vaccine. In January 2022, the FDA authorized the Pfizer COVID-19 vaccine for the third dose in some immunocompromised children aged 5-11. The information is continually updated, so it is beneficial to check the CDC’s website for the latest news. And if you have a child or loved one going through cancer treatment, please check with the child’s health care team before making any decisions related to the vaccine.
Here to Support in Uncertain Times
The pandemic has affected everyone in different ways. For some families, the pandemic has caused tragic loss of life and caused an emotional toll or financial hardship. For others, they have weathered the pandemic storm and gotten through it with minor issues. However, we choose to confront the virus, its control continues to touch us all. The pandemic will impact our lives for months and possibly years to come. The work of Here to Serve has continued throughout the past two years and will keep moving forward because, unfortunately, childhood cancer has not stopped during this time. We will continue to provide assistance and guidance for children and families going through the cancer fight.
By Chris Smith
About The Author
Chris Smith is a Here to Serve volunteer from the San Francisco Bay area who himself is a cancer survivor. He uses his professional experience as a technical writer to give back and provide clear and meaningful information for families with a child battling cancer.
All information on this blog is for informational and educational purposes only. Always consult a medical provider in your particular area of need before making significant changes in your medical decisions or lifestyle.