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
Articolo
Data di Pubblicazione:
2022
Citazione:
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 / Bandyopadhyay, Soham; Peter, Noel; Lakhoo, Kokila; Vieira Abib, Simone De Campos; Abdelhafeez, Hafeez; Wilson, Shaun; Pachl, Max; Martin, Benjamin; Nagras, Sonal; Sheth, Mihir; Dominic, Catherine; Gandhi, Suraj; Parwani, Divya; Raj, Rhea; Munezero, Diella; Dutta, Rohini; Roseline, Nsimire Mulanga; Mcclafferty, Kellie; Nazari, Armin; Sriram, Smrithi; Pillarisetti, Sai; Nweze, King-David; Ashwinee, Aishwarya; Kalra, Gul; Patil, Poorvaprabha; Nathani, Priyansh; Bhullar, Khushman Kaur; Elhadi, Muhammed; Khan, Maryam; Rahim, Nehal; Madhusudanan, Shweta; Erhabor, Joshua; Shirke, Manasi; Mughal, Aishah; Au, Darica; Salehi, Mahan; Royyuru, Sravani; Ahmed, Mohamed; Hussain, Syeda Namayah Fatima; Robinson, Daniel; Casey, Anna; Khan, Mehdi; Dukundane, Alexandre; Festus, Kwizera; Govind, Vaishnavi; Pancharatnam, Rohan; Ochieng, Lorraine; Taylor, Elliott H.; Nautiyal, Hritik; Crespo, Marta De Andres; Charuvil, Somy; Valetopoulou, Alexandra; Ravi, Krithi; Jalloh, Fatumata; Badwi, Nermin; Shah, Shahnur; Rajpal, Rohini; Rana, Masooma; Qadir, Muskaan Abdul; Uwiringiyimana, Emmanuel; Azzam, Abdelrahman; Fanelli, Mayara; Ataide Gomes, Gustavo Mendonca; Buarque, Igor Lima; Guerini, Isadora Schwaab; Bouderbala, Anfel; Alfurais, Sarah; Gamal, Mohamed; Hijazi, Yara; Tailakh, Shatha; Al-Naggar, Hamza; Douba, Zain; Elejla, Sewar; Eldaly, Abdullah; Sharashi, Ekram; Mansour, Ahmad; Elyan, Tamara; Nesrine, Aouabed; Ayman, Ammar; Zazo, Aya; Bonna, Mohamed; Lorabi, Safia; Alalami, Hassan; Emam, Rawan Yasser; Bwala, Kefas John; Umar, A. M.; Aremu, Abdurahaman; Suleiman, Dauda E.; Aliyu, Tybat; Saleem, Ayesha; Arshad, Muhammad; Turk, Kashaf; Altaf, Sadaf; Ogunsua, Oluseyi Oyebode; Sholadoye, Tunde Talib; Tolani, Musliu Adetola; Alfa, Yakubu; Mubarak, Keffi; Irungu, Eric Mwangi; Muma, Ken; Muma, Sarah; Obat, Mitchelle; Sameh, Youssef; Qasem, Abdulrahman Ghassan; Ayasra, Faris; Alnajjar, Reema; Abdel-Maboud, Mohamed; Bahaa, Abdelrahman; Saadeldin, Ayat M.; Adwi, Mohamed; Adly, Mahmoud; Elshenawy, Abdallah; Harky, Amer; Gentle, Leanne; Wright, Kirstie; Luyt, Jessica; White, Olivia; Smith, Charlotte; Thompson, Nathan; Smith, Thomas; Harrison, Imogen; Mitul, Ashrarur Rahman; Karim, Sabbir; Islam, Nazmul; Alsaeiti, Sara Kader; Benkhial, Fatma Saleh; Almihashhish, Mohammed Miftah Faraj; Burzeiza, Eman Salem Muftah; Masoud, Hend Mohammed; Alshamikh, Mabroukah Saeid; Nasef, Rajaari Mohammed; Mohammed, Fatma; Lo, William B.; Togarepi, Nyararai; Carrolan, Elaine; O'Sullivan, Benjamin J.; Hassanin, Mohamed; Saleh, Ahmed; Bassiony, Mahmoud; Qatora, Mostafa; Bahaaeldin, Mohamed; Fadel, Shady; El Chazli, Yasmine; Hamizi, Kamel; Zekkour, Mehdi Anouar; Rahmoun, Rima; Drid, Boutheyna; Abu Teir, Salma Naje; Kadir, Mohamed Yazid; Zerizer, Yassine; Khernane, Nacer; Saada, Brahim; Ammouze, Imane; Elkaoune, Yahya; Moujtahid, Hajar; Chaoui, Ghita; Benaouda, Hajar; Gounni, Meryem; Aji, Narjiss; Hessissen, Laila; Monteiro, Joana Mafalda; Nunes, Susana; do Bom-Sucesso, Maria; Lal, Dave R.; Craig, Brian T.; Becktell, Kerri; Banu, Tahmina; Alam, Md Afruzul; Pulock, Orindom Shing; Aziz, Tasmiah Tahera; Ilic, Rosanda; Grujicic, Danica; Nastasovic, Tijana; Lazic, Igor; Milicevic, Mihailo; Bascarevic, Vladimir; Mijalcic, Radovan; Scepanovic, Vuk; Stanimirovic, Aleksandar; Islam, Shahnoor; Basher, Akm Amirul Morshed A. K. M. Khairul; Akter, Mehnaz; Rahman, S. M. Rezanur; Ara, Zannat; Ahammed, Mohammed Tanvir; Akter, Tania; Nahar, Kamrun; Sayed, Fatema; Saracoglu, Kemal Tolga; Akova, Elif; Aydogmus, Evren; Kendirlioglu, Bekir Can; Hicdonmez, Tufan; Adhnon, Arshiya; Rana, Asim Noor; Humad, Hani; Madasu, Anjan; Azzam, Ahmed Y.; Azab, Mohammed A.; Ghozy, Sherief; Salah, Alzhraa; Moses, Olanrewaju; Taibat, Ibiyeye Taiye; Jones, Taiwo; Ukoha, Kalu; Goke, Olagundoye; Ikechukwu, Okorie; Idowu, Abiodun; Chitnis, Milind; N
Abstract:
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.
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.
Tipologia CRIS:
1.1 Articolo in rivista
Keywords:
global surgery; paediatric oncology; paediatrics; public health
Elenco autori:
Bandyopadhyay, Soham; Peter, Noel; Lakhoo, Kokila; Vieira Abib, Simone De Campos; Abdelhafeez, Hafeez; Wilson, Shaun; Pachl, Max; Martin, Benjamin; Nagras, Sonal; Sheth, Mihir; Dominic, Catherine; Gandhi, Suraj; Parwani, Divya; Raj, Rhea; Munezero, Diella; Dutta, Rohini; Roseline, Nsimire Mulanga; Mcclafferty, Kellie; Nazari, Armin; Sriram, Smrithi; Pillarisetti, Sai; Nweze, King-David; Ashwinee, Aishwarya; Kalra, Gul; Patil, Poorvaprabha; Nathani, Priyansh; Bhullar, Khushman Kaur; Elhadi, Muhammed; Khan, Maryam; Rahim, Nehal; Madhusudanan, Shweta; Erhabor, Joshua; Shirke, Manasi; Mughal, Aishah; Au, Darica; Salehi, Mahan; Royyuru, Sravani; Ahmed, Mohamed; Hussain, Syeda Namayah Fatima; Robinson, Daniel; Casey, Anna; Khan, Mehdi; Dukundane, Alexandre; Festus, Kwizera; Govind, Vaishnavi; Pancharatnam, Rohan; Ochieng, Lorraine; Taylor, Elliott H.; Nautiyal, Hritik; Crespo, Marta De Andres; Charuvil, Somy; Valetopoulou, Alexandra; Ravi, Krithi; Jalloh, Fatumata; Badwi, Nermin; Shah, Shahnur; Rajpal, Rohini; Rana, Masooma; Qadir, Muskaan Abdul; Uwiringiyimana, Emmanuel; Azzam, Abdelrahman; Fanelli, Mayara; Ataide Gomes, Gustavo Mendonca; Buarque, Igor Lima; Guerini, Isadora Schwaab; Bouderbala, Anfel; Alfurais, Sarah; Gamal, Mohamed; Hijazi, Yara; Tailakh, Shatha; Al-Naggar, Hamza; Douba, Zain; Elejla, Sewar; Eldaly, Abdullah; Sharashi, Ekram; Mansour, Ahmad; Elyan, Tamara; Nesrine, Aouabed; Ayman, Ammar; Zazo, Aya; Bonna, Mohamed; Lorabi, Safia; Alalami, Hassan; Emam, Rawan Yasser; Bwala, Kefas John; Umar, A. M.; Aremu, Abdurahaman; Suleiman, Dauda E.; Aliyu, Tybat; Saleem, Ayesha; Arshad, Muhammad; Turk, Kashaf; Altaf, Sadaf; Ogunsua, Oluseyi Oyebode; Sholadoye, Tunde Talib; Tolani, Musliu Adetola; Alfa, Yakubu; Mubarak, Keffi; Irungu, Eric Mwangi; Muma, Ken; Muma, Sarah; Obat, Mitchelle; Sameh, Youssef; Qasem, Abdulrahman Ghassan; Ayasra, Faris; Alnajjar, Reema; Abdel-Maboud, Mohamed; Bahaa, Abdelrahman; Saadeldin, Ayat M.; Adwi, Mohamed; Adly, Mahmoud; Elshenawy, Abdallah; Harky, Amer; Gentle, Leanne; Wright, Kirstie; Luyt, Jessica; White, Olivia; Smith, Charlotte; Thompson, Nathan; Smith, Thomas; Harrison, Imogen; Mitul, Ashrarur Rahman; Karim, Sabbir; Islam, Nazmul; Alsaeiti, Sara Kader; Benkhial, Fatma Saleh; Almihashhish, Mohammed Miftah Faraj; Burzeiza, Eman Salem Muftah; Masoud, Hend Mohammed; Alshamikh, Mabroukah Saeid; Nasef, Rajaari Mohammed; Mohammed, Fatma; Lo, William B.; Togarepi, Nyararai; Carrolan, Elaine; O'Sullivan, Benjamin J.; Hassanin, Mohamed; Saleh, Ahmed; Bassiony, Mahmoud; Qatora, Mostafa; Bahaaeldin, Mohamed; Fadel, Shady; El Chazli, Yasmine; Hamizi, Kamel; Zekkour, Mehdi Anouar; Rahmoun, Rima; Drid, Boutheyna; Abu Teir, Salma Naje; Kadir, Mohamed Yazid; Zerizer, Yassine; Khernane, Nacer; Saada, Brahim; Ammouze, Imane; Elkaoune, Yahya; Moujtahid, Hajar; Chaoui, Ghita; Benaouda, Hajar; Gounni, Meryem; Aji, Narjiss; Hessissen, Laila; Monteiro, Joana Mafalda; Nunes, Susana; do Bom-Sucesso, Maria; Lal, Dave R.; Craig, Brian T.; Becktell, Kerri; Banu, Tahmina; Alam, Md Afruzul; Pulock, Orindom Shing; Aziz, Tasmiah Tahera; Ilic, Rosanda; Grujicic, Danica; Nastasovic, Tijana; Lazic, Igor; Milicevic, Mihailo; Bascarevic, Vladimir; Mijalcic, Radovan; Scepanovic, Vuk; Stanimirovic, Aleksandar; Islam, Shahnoor; Basher, Akm Amirul Morshed A. K. M. Khairul; Akter, Mehnaz; Rahman, S. M. Rezanur; Ara, Zannat; Ahammed, Mohammed Tanvir; Akter, Tania; Nahar, Kamrun; Sayed, Fatema; Saracoglu, Kemal Tolga; Akova, Elif; Aydogmus, Evren; Kendirlioglu, Bekir Can; Hicdonmez, Tufan; Adhnon, Arshiya; Rana, Asim Noor; Humad, Hani; Madasu, Anjan; Azzam, Ahmed Y.; Azab, Mohammed A.; Ghozy, Sherief; Salah, Alzhraa; Moses, Olanrewaju; Taibat, Ibiyeye Taiye; Jones, Taiwo; Ukoha, Kalu; Goke, Olagundoye; Ikechukwu, Okorie; Idowu, Abiodun; Chitnis, Milind; Nauhaus, Helga; Erwee, Danelle; Brown, Robyn; Chylinska, Agata; Simpson, Robin; Gomes, Prasanna; Ciriaco Padilha, Marco Aurelio; De Oliveira Junior, Elvercio Pereira; De Carvalho, Luc
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