Although the registry provides information about how children with cancer have fared so far during the pandemic, it does not capture information on specific SARS-CoV-2 variants or other impacts on care that are harder to track and quantify.
“During the first wave of the pandemic, we were forced to stop recruitment in a clinical trial for pediatric ALL [InPOG ICiCLe-ALL-14],” said Arpita Bhattacharyya, MBBS, a consultant oncologist at the Tata Medical Center in Kolkata, India, who submitted data to the registry.
“Treatment interruptions were frequent, and children were still treated on the study protocol but off trial. We couldn’t deliver certain care or procedures on time. We don’t know what the long-term implications of this will be,” Dr Bhattacharyya added.
India went into lockdown about 2 months after the first COVID-19 case was reported in the country.5 After restrictions began to lift, patients who tested positive for SARS-CoV-2 were still required to quarantine for 17 days.6 In Dr Bhattacharyya’s hospital, a negative COVID-19 test result was required before beginning any diagnostic or treatment procedures.
“When we suspected leukemia or a solid tumor, and the child tested positive for COVID-19, we couldn’t do anything about it for 17 days; no further tests to confirm the diagnosis and no treatment,” Dr Bhattacharyya explained.
“A child who would have been diagnosed in less than 24 hours had to come back after weeks, and, in some cases, the disease progressed. And a lot of children, unfortunately, never came back. It was one of the greatest feelings of helplessness that we have encountered.”
In Kolkata, the hospital now has a dedicated COVID-19 isolation ward for vulnerable patients who have COVID-19. In pediatric oncology, they have successfully pivoted to telehealth for some of their work.
Pediatric oncology departments worldwide have adopted similar infection control and risk-minimizing strategies.
“A lot of preventative measures we would recommend are things that parents and patients already do for children with cancer; for example, masking and hand hygiene,” Dr Mukkada said. “We also emphasize the point of vaccinating people around the patient, as well as the patient themselves if eligible.”
Dr Mukkada and colleagues hope the registry findings will inform clinical practice guidelines and bring attention to the fact that children with cancer are at high risk of developing severe COVID-19.
“As we look forward to the future for this registry, I’d hoped that we were going to close it, and that we’d be done with the pandemic as well this year,” Dr Mukkada said. “But it turns out that we’re not done yet, and the new variants especially have shown us that we need to keep going because we may discover new things.”
The registry is open and accepting new data.
Disclosures: Dr Mukkada and Dr Bhattacharyya reported having no relevant conflicts of interest.
1. Mukkada S, Bhakta N, Chantada GL, et al. Global characteristics and outcomes of SARS-CoV-2 infection in children and adolescents with cancer (GRCCC): A cohort study. Lancet Oncol. Published online August 26, 2021. doi:10.1016/S1470-2045(21)00454-X
2. Boulad F, Kamboj M, Bouvier N, Mauguen A, Kung AL. COVID-19 in children with cancer in New York City. JAMA Oncol. 2020;6(9):1459-1460. doi:10.1001/jamaoncol.2020.2028
3. Children’s Cancer and Leukemia Group. Coronavirus data. Published May 18, 2020. Accessed September 13, 2021. https://www.cclg.org.uk/coronavirus-data
4. COVID-19 and Childhood Cancer Registry. Global Registry of COVID-19 in pediatric cancer. Accessed September 13, 2021. https://global.stjude.org/en-us/global-covid-19-observatory-and-resource-center-for-childhood-cancer/registry.html
5. Bharali I, Kumar P, Selvaraj S. How well is India responding to COVID-19? Brookings. Published July 2, 2020. Accessed September 13, 2021. https://www.brookings.edu/blog/future-development/2020/07/02/how-well-is-india-responding-to-covid-19/
6. Government of India Ministry of Health & Family Welfare. Revised guidelines for home isolation of very mild/pre-symptomatic COVID-19 cases. Published May 10, 2020. Accessed September 13, 2021. https://www.mohfw.gov.in/pdf/RevisedguidelinesforHomeIsolationofverymildpresymptomaticCOVID19cases10May2020.pdf