A cohort study of COVID-19 infection in pediatric oncology patients and
the utility of remdesivir treatment
Abstract
Introduction Pediatric oncology patients are reportedly at risk
for progression to severe Coronavirus disease-2019 (COVID-19) infection.
Data on the safety and clinical effectiveness of remdesivir in children
with cancer remains scarce. The main aims of this study were to describe
COVID-19 infection in this cohort and to evaluate the utility of
remdesivir treatment in terms of the time to viral clearance and its
safety profile. Methods This was a retrospective observational
cohort study of pediatric oncology patients ≤18 years of age with
SARS-CoV-2 polymerase chain reaction (PCR) confirmed infection. Patients
were admitted to KK Women’s and Children’s Hospital from 1
st November 2021 to 31 st March
2022. Clinical data, investigations and laboratory tests results were
collected. Results Eighteen patients were included. Median age
was 6.5 years (IQR: 4.64 – 9.83), and there were 13 males (72.2%). The
immunosuppressive status of the cohort was: severe (n = 3, 22.2%),
moderate (n = 9, 50.0%) and low (5, 27.8%). All patients had mild
COVID-19 infection, and there were no COVID-19 attributed deaths.
Remdesivir was initiated in four patients. We did not detect any benefit
in terms of time to viral clearance or SARS-CoV2 PCR cycle threshold ≥25
between the treated versus non-treated groups. Remdesivir was well
tolerated with no safety concerns. Conclusion Our cohort of
immunocompromised pediatric oncology patients all had mild clinical
COVID-19 with no directly attributable morbidity and mortality. In four
patients, treatment with remdesivir was safe but did not lead to early
viral clearance.