Journal article
COVID-19 infection in children, adolescents, and young adults with Down syndrome and hematologic malignancies
Pediatric blood & cancer, Vol.71(8), e31082
05/28/2024
DOI: 10.1002/pbc.31082
PMID: 38804869
Abstract
Introduction
Children, adolescents, and young adults (CAYAs) with Down syndrome (DS) and hematologic malignancies are particularly vulnerable to infections and related complications. There are limited data regarding COVID-19 infections in this group. We aimed to understand the clinical course of COVID-19 in this population.
Methods
This observational study leverages the de-identified clinical and sociodemographic data captured by the Pediatric Oncology COVID-19 Case Report Registry (POCC) regarding CAYAs with cancer and COVID-19. We evaluated CAYAs (≤21 years at COVID-19 infection) with hematologic malignancies and COVID-19 reported from April 1, 2020 to May 2, 2023, comparing those with and without DS. Using multivariable logistic regression, we examined rates of hospitalization, intensive care unit (ICU) admission, respiratory support, and changes in cancer-directed therapy.
Results
Among 1408 CAYAs with hematologic malignancies, 55 had DS (CAYA-DS). CAYA-DS had higher rates of hospitalization, ICU admission, and respiratory support (p < .001) than CAYAs without DS. Similarly, multivariable analyses found higher odds of hospitalization (odds ratio [OR] = 2.8, 95% confidence interval [CI]: 1.5–5.1), ICU admission (OR = 4.2, 95% CI: 1.9–9.1), and need for respiratory support (OR = 4.2, 95% CI: 2.0–8.8) among CAYA-DS. Modifications to cancer-directed therapy were more common among CAYA-DS when related to neutropenia (p = .001), but not when unrelated to neutropenia (p = .88); CAYA-DS did not have higher odds of changes to cancer-directed therapy (OR = 1.20, 95% CI: 0.7–2.1).
Conclusions
We identify CAYA-DS with hematologic malignancies as a vulnerable subpopulation at greater risk for severe COVID-19 infection. This can inform conversations with patients and families regarding therapeutic and preventive measures, as well as the risks and benefits of modifying chemotherapy in the setting of COVID-19.
Details
- Title: Subtitle
- COVID-19 infection in children, adolescents, and young adults with Down syndrome and hematologic malignancies
- Creators
- Blake Foxworthy - University of Alabama at BirminghamChen Dai - University of Alabama at BirminghamElizabeth C Davis - Boston UniversityAna C Xavier - University of Alabama at BirminghamJulienne Brackett - Baylor College of MedicineDavid Dickens - University of IowaAlissa Kahn - St. Joseph’s University Medical CenterIsaac Martinez - University of Alabama at BirminghamArchana Sharma - Rutgers, The State University of New JerseyCarla Schwalm - Bronson Methodist HospitalJessica Foley - Helen DeVos Children's HospitalJennifer Wilkes - University of WashingtonSmita Bhatia - University of Alabama at BirminghamJennifer M Levine - Center for Cancer and Blood DisordersEmily E Johnston - University of Alabama at BirminghamJulie A Wolfson - University of Alabama at Birmingham
- Resource Type
- Journal article
- Publication Details
- Pediatric blood & cancer, Vol.71(8), e31082
- DOI
- 10.1002/pbc.31082
- PMID
- 38804869
- eISSN
- 1545-5017
- Language
- English
- Electronic publication date
- 05/28/2024
- Academic Unit
- Stead Family Department of Pediatrics; Hematology/Oncology
- Record Identifier
- 9984630758802771
Metrics
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