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Objectives: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs.

Design: A multicentre, international, collaborative cohort study.

Setting: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020.

Participants: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer.

Main Outcome Measure: All-cause mortality at 30 days and 90 days.

Results: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001).

Conclusions: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally.

Competing Interests: Competing interests: None declared.

Titel:	Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study.
Link:	Zum Volltext
Zeitschrift:	BMJ open, Jg. 12 (2022-04-11), Heft 4, S. e054690
Veröffentlichung:	[London] : BMJ Publishing Group Ltd, 2011-, 2022
Medientyp:	academicJournal
ISSN:	2044-6055 (electronic)
DOI:	10.1136/bmjopen-2021-054690
Schlagwort:	Adolescent Child Cohort Studies Developed Countries Developing Countries Humans Pandemics COVID-19 epidemiology Hodgkin Disease Retinal Neoplasms
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Corporate Authors: Global Health Research Group on Children’s Non-Communicable Diseases Collaborative Publication Type: Journal Article; Multicenter Study; Observational Study Language: English [BMJ Open] 2022 Apr 11; Vol. 12 (4), pp. e054690. <i>Date of Electronic Publication: </i>2022 Apr 11. MeSH Terms: COVID-19* / epidemiology ; Hodgkin Disease* ; Retinal Neoplasms* ; Adolescent ; Child ; Cohort Studies ; Developed Countries ; Developing Countries ; Humans ; Pandemics References: J Pediatr Hematol Oncol. 2012 Mar;34 Suppl 1:S1-11. (PMID: 22357142) ; Lancet Oncol. 2019 Apr;20(4):483-493. (PMID: 30824204) ; Lancet Oncol. 2020 Jun;21(6):753-755. (PMID: 32437662) ; Lancet Child Adolesc Health. 2021 May;5(5):332-340. (PMID: 33675698) ; Neuro Oncol. 2020 Dec 18;22(12):1884-1886. (PMID: 32623465) ; JCO Glob Oncol. 2020 Sep;6:1428-1438. (PMID: 32986516) ; J Clin Epidemiol. 2008 Apr;61(4):344-9. 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(PMID: 18672210) Contributed Indexing: Investigator: S Bandyopadhyay; N Peter; K Lakhoo; S Campos Vieira Abib; H Abdelhafeez; S Wilson; M Pachl; B Martin; S Nagras; M Sheth; C Dominic; S Gandhi; D Parwani; R Raj; D Munezero; R Dutta; NM Roseline; K McClafferty; A Nazari; S Sriram; S Pillarisetti; K Nweze; A Ashwinee; G Kalra; P Patil; P Nathani; KK Bhullar; M Elhadi; M Khan; N Rahim; S Madhusudanan; J Erhabor; M Shirke; A Mughal; D Au; M Salehi; S Royyuru; M Ahmed; S Namayah Fatima Hussain; D Robinson; A Casey; M Khan; A Dukundane; K Festus; V Govind; R Pancharatnam; L Ochieng; EH Taylor; H Nautiyal; M Andres Crespo; S Charuvila; A Valetopoulou; K Ravi; F Jalloh; N Badwi; S Shah; G Kalra; R Rajpal; M Rana; M Abdul Qadir; E Uwiringiyimana; A Azzam; M Fanelli; G Mendonça Ataíde Gomes; I Lima Buarque; I Schwaab Guerini; A Bouderbala; S Alfurais; M Gamal; Y Hijazi; S Tailakh; H AlNaggar; Z Douba; S Elejla; A Eldaly; E Sharashi; A Mansour; T Elyan; A Nesrine; A Ayman; A Zazo; M Bonna; S Lorabi; H Alalami; R Yasser Emam; S Bandyopadhyay; R Dutta; S Madhusudanan; S Gandhi; M Khan; R Raj; M Alser; M K Abou Chaar; D Mazingi; H Zuberi; I Sultan; D Nath Ghosh; N James Peters; RM Baertschiger; A Zani; N Peter; K Lakhoo; L Davies; S Bandyopadhyay; KJ Bwala; AM Umar; A Aremu; DE Suleiman; T Aliyu; A Saleem; M Arshad; K Turk; S Altaf; OO Ogunsua; TT Sholadoye; MA Tolani; Y Alfa; KM Musa; M Irungu; K Muma; S Muma; M Obat; YS Badran; AG Qasem; F Ayasra; R Alnajjar; M Abdel-Maboud; A Bahaa; AM Saadeldin; M Adwi; M Adly; A Elshenawy; A Harky; L Gentle; K Wright; J Luyt; O White; C Smith; N Thompson; T Smith; I Harrison; AR Mitul; S Karim; N Islam; SK Alsaeiti; FS Benkhial; MM Faraj Almihashhish; ES Muftah Burzeiza; RM Mohammed Nasef; HM Masoud; MS Alshamikh; FM Masoud; WB Lo; N Togarepi; E Carrolan; B Martin; M Pachl; J Benjamin; MH O'Sullivan; A Saleh; M Bassiony; M Qatora; M Bahaaeldin; S Fadel; YE Chazli; A Bouderbala; K Hamizi; S Lorabi; MA Zekkour; R Rahmoun; B Drid; SNA Teir; S Lorabi; MY Kadir; Y Zerizer; N Khernane; B Saada; I Ammouze; Y Elkaoune; H Moujtahid; G Chaoui; H Benaouda; M Gounni; N Aji; L Hessissen; JM Monteiro; S Nunes; MD Bom-Sucesso; DR Lal; BT Craig; K Becktell; T Banu; MA Alam; OS Pulock; TT Aziz; R Ilic; D Grujicic; T Nastasovic; I Lazic; M Milicevic; V Bascarevic; R Mijalcic; V Scepanovic; A Stanimirovic; A Paunovic; I Bogdanovic; S Islam; A Amirul Morshed; AKM Khairul Basher; M Akter; SM Rezanur Rahman; Z Ara; MT Ahammed; T Akter; K Nahar; F Sayed; A Nabi; MA Iqbal; MM Rana; M Asaduzzaman; M Hasanuzzaman; KT Saracoglu; E Akova; E Aydogmus; BC Kendirlioglu; T Hicdonmez; A Adhnon; AN Rana; H Humad; A Madasu; AY Azzam; MA Azab; S Ghozy; AS Abbas; O Moses; IT Taibat; T Jones; K Ukoha; O Goke; O Ikechukwu; AI Okunlola; M Chitnis; H Nauhaus; D Erwee; R Brown; A Chylinska; R Simpson; P Gomes; N Peter; MA Ciriaco Padilha; EP de Oliveira Junior; LG Carvalho; FL Diz; ME Kassas; U Eldaly; A Tawheed; M Abdelwahab; OM Yassaad; B Hajar; EO Abdessamad; A Yasser; H Laila; FS Yahya; Y Al-Agele; MTP Gallardo; JEM Vásquez; JLG León; SS Yip; M Lami; MHV Byrne; D Jasim; H Ghattaura; S Bandyopadhyay; K Lakhoo; EW Etchill; D Rhee; S Cooper; K Crow; M Drucker; M Murphy; B Shou; A Siegel; Y Kara; GN Özdemir; M Elfiky; EE Refaee; JG Massoud; AB Ibrahim; RB Ibrahim; FA Za'nouneh; RM Baddourah; T Fahmawee; A Al Shraideh; G Salman; E Alameer; AM Ali; G Yahia; K Waleed; MK Abou Chaar; I Sultan; K Ghandour; S Al-Dabaibeh; A Al-Basiti; H Ababneh; O El-Qurneh; Y Alalawi; AA Ayed; E Hanafy; NA Bolowi; AH Loh; AS Jacobsen; H Barola; AL Pagaduan; J Fan; OA Elebute; AO Ademuyiwa; CO Bode; JO Seyi-Olajide; O Ladipo-Ajayi; FM Alakaloko; GC Ihediwa; KO Musa; EO Temiye; O Oni; AM Akinsete; J Zarrish; R Saleem; S Zahid; A Amirali; A Nadeem; SS Tebha; Z Qayyum; S Tahir; A Tahir; RR Khan; A Mehmood; M Arshad; TI Qureshi; P Kumari; V Calvagna; N Galea; A Axiaq; MR Schuelke; JA Kloebe; RL Owen; AS Roth; C Yang; J Hudson Barnett; LP Jay; KD Wyatt; PJ Galardy; A Vojcek; MMA Alrahawy; SM Ragab; AR Allam; EI Hager; A Azzam; A Ayman; KK Cerit; A Dağçınar; T Umuroğlu; A Saraçoğlu; M Sakar; C Kıvrak; G Çakmak; I Sallam; G Amira; M Sherief; A Sherif; SO Coelho; A Ikeda; L Portela; MM Garrigo; RV Carvalho; F Lobo; SE Ferman; FFDS Lima; MMA Elhassan; NOY Elhaj; HKS Hamid; EA Ameh; VE Nwatah; AB Oyesakin; AN Osuigwe; OH Ekwunife; CA Nri-Ezedi; EO Umeh; N Patiala; IO Ogundele; AF Adekanmbi; OM Fatungase; OO Obadaini; S Al-Furais; H Hemlae; S Nay; J Mathew; RM Jeffri Ismail; SCV Abib; FAMC Carlesse; MCA Fanelli; FKM Souza; P Lapolla; A Mingoli; D Cozzi; AM Testi; P Musiu; P Sapienza; G Brachini; M Zambon; S Meneghini; P Cicerchia; B Cirillo; G Salman; AO Taha; A Nesrine; B Souad; M Malika; B Belkacem; A Meelad; HS Alrashed; F Haider; FNA Fayez; F Rahim; A Abdul-Mumin; HY Fuseini; PG Kwarteng; AB Abdulai; SMP Kunfah; GB Bonsaana; S Ajinkpang; EM Der; FA Abantanga; MJ Kpiniong; KA Hattor; KA Bimpong; M Elbahnasawy; S Abdelsalam; A Samir; RM Baertschiger; A Brar; AC Matei; A Zani; L Samad; HK Zuberi; K Nadeem; N Khayyam; FA Imran; N Zia; S Muhammad; MR Raza; MR Khan; A Hamdan; A Mazloum; A Abodest; N Ali; B Gawarieh; A Omran; A Moussa; A Ahmed; M Hraib; V Khoury; A Almjersah; MA Deeb; A Alkhalil; A Ahmed; M Ahmad; A Alelayan; A Hammed; W Shater; A Bouhuwaish; A Abdulkarim; E Abdulwahed; M Biala; R Ghamgh; A Alamre; M Shelft; AAM Albanna; H Tawel; E Hatzipantelis; A Tragiannidis; E Tsotridou; A Galli-Tsinopoulou; DAA Aziz; ZA Latiff; H Alias; CK Loh; D Lau; AS Khutubul; RN Vuille-Dit-Bille; SG Holland-Cunz; N Allafi; TA Lawal; KI Egbuchulem; OO Ogundoyin; ID Olulana; BJ Brown; OJ Afolaranmi; A Fehintola; A Heuer; C Nitschke; M Boettcher; M Priemel; L Viezens; M Stangenberg; M Dreimann; A Reiter; J Meyer; L Köpke; KH Frosch; S Olori; U Offiong; PM Mshelbwala; FA Patrick; AM Umar; N Otene ThankGod; AA Nasir; KOO Ibrahim; DS Ademola-Popoola; OT Sayomi; A Abdurrzzaq; AA Adeyeye; KO Omokanye; LO Abdur-Rahman; OO Bamidele; S AbdulAzeez; A Akinoso; MO Adegboye; SA Nah; YJ Ng; SA Zubaidi; M Almasri; S Ali; R Olaosebikan; A Muthukumar; P Shinondo; A Ngongola; B Bvulani; A Patel; A Nuhu-Koko; B Jibrin; AL Olalekan; CS Lukong; EI Ajayi; G Guillén; S López; JA Molino; P Velasco; O Elmandouh; O Hamam; R Elmandouh; NM Ruzgar; R Levinson; S Kala; S Ullrich; E Christison-Lagay; AS Mortada; MA Ebada; ESA Solimam; K Abualkher; AME Yousf; MM Holail; RM Almowafy; SEO Kacimi; F Haider; T Banu; AR Mitul; SCV Abib; JHL Wong; R Baertschiger; E Elhalaby; M Alser; MM Saad; G Seitz; J Lindbert; FAG Tsoulfas; A Galli-Tsinopoulou; A Vojcek; MG Adel; AO Taha; C Virgone; F Pata; G Gallo; MK Abou Chaar; F Ayasra; EM Irungu; M Elhadi; SA Nah; DAA Aziz; V Calvagna; O Oumaima; Z Bentounsi; A Ademuyiwa; DN Ghosh; M Arshad; L Samad; L Saldana; J Godzinsky; A Ali; E Alameer; D Janic; MB Jalloh; N Bell; A Jacobsen; CH Chui; M Chitnis; IF Pineda; L Krauel; M Olivos; W Rahama; H Elfatih; RN Vuille-Dit-Bille; A Hamdan; A Isik; AN Rana; K Lakhoo; K Cross; M Pachl; A Hayes-Jordan; R Dasgupta; P Shinondo; A Ngongola; M Elshami ; Keywords: paediatric oncology; paediatrics; public health Entry Date(s): Date Created: 20220412 Date Completed: 20220413 Latest Revision: 20220716 Update Code: 20231215 PubMed Central ID: PMC9021459

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Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study.