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A cohort study of COVID-19 infection in pediatric oncology patients and the utility of remdesivir treatment
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  • Rina Yue Ling Ong,
  • Valerie Xue Fen Seah,
  • Chia-Yin Chong,
  • Koh Cheng Thoon,
  • Natalie Woon Hui Tan,
  • Jiahui Li,
  • Karen Donceras Nadua,
  • Shui Yen Soh,
  • Michaela Su-Fern Seng,
  • Thi Ngoc Anh Pham,
  • Chee Fu Yung,
  • Kai-Qian Kam
Rina Yue Ling Ong
KK Women's and Children's Hospital

Corresponding Author:rina.ong.yl@kkh.com.sg

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Valerie Xue Fen Seah
KK Women's and Children's Hospital
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Chia-Yin Chong
KK Women's and Children's Hospital
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Koh Cheng Thoon
KK Women's and Children's Hospital
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Natalie Woon Hui Tan
KK Women's and Children's Hospital
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Jiahui Li
KK Women's and Children's Hospital
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Karen Donceras Nadua
KK Women's and Children's Hospital
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Shui Yen Soh
KK Women's and Children's Hospital
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Michaela Su-Fern Seng
KK Women's and Children's Hospital
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Thi Ngoc Anh Pham
KK Women's and Children's Hospital
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Chee Fu Yung
KK Women's and Children's Hospital
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Kai-Qian Kam
KK Women's and Children's Hospital
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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.