Children with cancer experience mild symptoms and fully recover from COVID-19

Most children and adolescents with cancer experience mild symptoms and fully recover after being infected with COVID-19, according to a small international study.

However, pediatric cancer patients who have other underlying health problems (comorbidities), severe infections (mainly bacterial) and low white blood cells (indication of immunosuppression) are significantly more likely to have severe COVID-19.  About one in ten children will need to be admitted to an intensive care unit (ICU).

Researchers at Goethe University in Frankfurt and the Murdoch Children's Research Institute in Australia studied data on 131 children under the age of 19 diagnosed with coronavirus in ten countries.  The children had also been diagnosed with cancer (60% leukemia/lymphoma and 37% solid tumor) or had had a bone marrow stem cell transplant. 

The results showed that one-third of these children (32%) with COVID-19 were found to be asymptomatic, 47% had very few to mild symptoms, 8% had moderate COVID-19, and 4% had severe Covid-19 and 9% were in critical condition.  The findings were published in the European Journal of Cancer.

Results also showed that 37% needed hospitalization, 11% ICU admission and four children (3%) died, while 95% fully recovered. One-third of children with cancer who were on anti-cancer treatment when they became ill with coronavirus needed to delay chemotherapy or change their doses.

The researchers found it important that these changes were not associated with a reduced risk of severe COVID-19. There was no difference in the proportion of children with symptomatic COVID-19 infection between those who received anticancer treatment and those who completed it when they became infected with the coronavirus.

The most common symptoms of COVID-19 in children with cancer were fever (71%), cough (47%), runny nose-rhinitis (29%) and gastrointestinal disorders. The median duration of infection was 16 days, although in some children the coronavirus could be detected up to 80 days after the initial diagnosis of infection.

Children with cancer or a related history are a priority group for vaccination. Most COVID-19 infections in these patients, according to the researchers, occur within their family through the transmission of the coronavirus from another member, so the whole family or other caregivers should be vaccinated.