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. Issue 4 (11th April 2022)

• Record Type: Journal Article
• Other Names: Bandyopadhyay Soham author non-byline.; Peter Noel author non-byline.; Lakhoo Kokila author non-byline.; Campos Vieira Abib Simone de author non-byline.; Abdelhafeez Hafeez author non-byline.; Wilson Shaun author non-byline.; Pachl Max author non-byline.; Martin Benjamin author non-byline.; Nagras Sonal author non-byline.; Sheth Mihir author non-byline.; Dominic Catherine author non-byline.; Gandhi Suraj author non-byline.; Parwani Divya author non-byline.; Raj Rhea author non-byline.; Munezero Diella author non-byline.; Dutta Rohini author non-byline.; Roseline Nsimire Mulanga author non-byline.; McClafferty Kellie author non-byline.; Nazari Armin author non-byline.; Sriram Smrithi author non-byline.; Pillarisetti Sai author non-byline.; Nweze KingDavid author non-byline.; Ashwinee Aishwarya author non-byline.; Kalra Gul author non-byline.; Patil Poorvaprabha author non-byline.; Nathani Priyansh author non-byline.; Bhullar Khushman Kaur author non-byline.; Elhadi Muhammed author non-byline.; Khan Maryam author non-byline.; Rahim Nehal author non-byline.; Madhusudanan Shweta author non-byline.; Erhabor Joshua author non-byline.; Shirke Manasi author non-byline.; Mughal Aishah author non-byline.; Au Darica author non-byline.; Salehi Mahan author non-byline.; Royyuru Sravani author non-byline.; Ahmed Mohamed author non-byline.; Namayah Fatima Hussain Syeda author non-byline.; Robinson Daniel author non-byline.; Casey Anna author non-byline.; Khan Mehdi author non-byline.; Dukundane Alexandre author non-byline.; Festus Kwizera author non-byline.; Govind Vaishnavi author non-byline.; Pancharatnam Rohan author non-byline.; Ochieng Lorraine author non-byline.; Taylor Elliott H author non-byline.; Nautiyal Hritik author non-byline.; Andres Crespo Marta de author non-byline.; Charuvila Somy author non-byline.; Valetopoulou Alexandra author non-byline.; Ravi Krithi author non-byline.; Jalloh Fatumata author non-byline.; Badwi Nermin author non-byline.; Shah Shahnur author non-byline.; Kalra Gul author non-byline.; Rajpal Rohini author non-byline.; Rana Masooma author non-byline.; Abdul Qadir Muskaan author non-byline.; Uwiringiyimana Emmanuel author non-byline.; Azzam Abdelrahman author non-byline.; Fanelli Mayara author non-byline.; Mendonça Ataíde Gomes Gustavo author non-byline.; Lima Buarque Igor author non-byline.; Schwaab Guerini Isadora author non-byline.; Bouderbala Anfel author non-byline.; Alfurais Sarah author non-byline.; Gamal Mohamed author non-byline.; Hijazi Yara author non-byline.; Tailakh Shatha author non-byline.; AlNaggar Hamza author non-byline.; Douba Zain author non-byline.; Elejla Sewar author non-byline.; Eldaly Abdullah author non-byline.; Sharashi Ekram author non-byline.; Mansour Ahmad author non-byline.; Elyan Tamara author non-byline.; Nesrine Aouabed author non-byline.; Ayman Ammar author non-byline.; Zazo Aya author non-byline.; Bonna Mohamed author non-byline.; Lorabi Safia author non-byline.; Alalami Hassan author non-byline.; Yasser Emam Rawan author non-byline.; Bandyopadhyay Soham author non-byline.; Dutta Rohini author non-byline.; Madhusudanan Shweta author non-byline.; Gandhi Suraj author non-byline.; Khan Mehdi author non-byline.; Raj Rhea author non-byline.; Alser Muath author non-byline.; K Abou Chaar Mohamad author non-byline.; Mazingi Dennis author non-byline.; Zuberi Hira author non-byline.; Sultan Iyad author non-byline.; Nath Ghosh Dhruv author non-byline.; James Peters Nitin author non-byline.; Baertschiger Reto M author non-byline.; Zani Augusto author non-byline.; Peter Noel author non-byline.; Lakhoo Kokila author non-byline.; Davies Lucy author non-byline.; Bandyopadhyay Soham author non-byline.; Bwala Kefas John author non-byline.; Umar AM author non-byline.; Aremu Abdurahaman author non-byline.; Suleiman Dauda E author non-byline.; Aliyu Tybat author non-byline.; Saleem Ayesha author non-byline.; Arshad Muhammad author non-byline.; Turk Kashaf author non-byline.; Altaf Sadaf author non-byline.; Ogunsua Oluseyi Oyebode author non-byline.; 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Karim Sabbir author non-byline.; Islam Nazmul author non-byline.; Alsaeiti Sara Kader author non-byline.; Benkhial Fatma Saleh author non-byline.; Faraj Almihashhish Mohammed Miftah author non-byline.; Muftah Burzeiza Eman Salem author non-byline.; Mohammed Nasef Raja Mari author non-byline.; Masoud Hend Mohammed author non-byline.; Alshamikh Mabroukah Saeid author non-byline.; Masoud Fatma Mohammed author non-byline.; Lo William B author non-byline.; Togarepi Nyararai author non-byline.; Carrolan Elaine author non-byline.; Martin Benjamin author non-byline.; Pachl Max author non-byline.; Benjamin J author non-byline.; O'Sullivan Mohamed Hassanin author non-byline.; Saleh Ahmed author non-byline.; Bassiony Mahmoud author non-byline.; Qatora Mostafa author non-byline.; Bahaaeldin Mohamed author non-byline.; Fadel Shady author non-byline.; Chazli Yasmine El author non-byline.; Bouderbala Anfel author non-byline.; Hamizi Kamel author non-byline.; Lorabi Safia author non-byline.; Zekkour Mehdi Anouar author non-byline.; 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Lazic Igor author non-byline.; Milicevic Mihailo author non-byline.; Bascarevic Vladimir author non-byline.; Mijalcic Radovan author non-byline.; Scepanovic Vuk author non-byline.; Stanimirovic Aleksandar author non-byline.; Paunovic Aleksandra author non-byline.; Bogdanovic Ivan author non-byline.; Islam Shahnoor author non-byline.; Amirul Morshed AKM author non-byline.; Khairul Basher A. 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Masud author non-byline.; Asaduzzaman Md. author non-byline.; Hasanuzzaman Md. author non-byline.; Saracoglu Kemal Tolga author non-byline.; Akova Elif author non-byline.; Aydogmus Evren author non-byline.; Kendirlioglu Bekir Can author non-byline.; Hicdonmez Tufan author non-byline.; Adhnon Arshiya author non-byline.; Rana Asim Noor author non-byline.; Humad Hani author non-byline.; Madasu Anjan author non-byline.; Azzam Ahmed Y author non-byline.; Azab Mohammed A author non-byline.; Ghozy Sherief author non-byline.; Abbas Alzhraa Salah author non-byline.; Moses Olanrewaju author non-byline.; Taibat Ibiyeye Taiye author non-byline.; Jones Taiwo author non-byline.; Ukoha Kalu author non-byline.; Goke Olagundoye author non-byline.; Ikechukwu Okorie author non-byline.; Okunlola Abiodun Idowu author non-byline.; Chitnis Milind author non-byline.; Nauhaus Helga author non-byline.; Erwee Danelle author non-byline.; Brown Robyn author non-byline.; Chylinska Agata author non-byline.; Simpson Robin author non-byline.; Gomes Prasanna author non-byline.; Peter Noel author non-byline.; Ciriaco Padilha Marco Aurelio author non-byline.; de Oliveira Junior Elvercio Pereira author non-byline.; Carvalho Lucas Garschagen de author non-byline.; Diz Fabiola Leonelli author non-byline.; Kassas Mohamed El author non-byline.; Eldaly Usama author non-byline.; Tawheed Ahmed author non-byline.; Abdelwahab Mohamed author non-byline.; Yassaad Oudrhiri Mohammed author non-byline.; Hajar Bechri author non-byline.; Abdessamad El Ouahabi author non-byline.; Yasser Arkha author non-byline.; Laila Hessissen author non-byline.; Yahya Farah Sameer author non-byline.; Al-Agele Yasir author non-byline.; Gallardo Maria Teresa Peña author non-byline.; Vásquez Jacqueline Elizabeth Montoya author non-byline.; León Juan Luis García author non-byline.; Yip Sebastián Shu author non-byline.; Lami Mariam author non-byline.; Byrne Matthew H V author non-byline.; Jasim Duha author non-byline.; Ghattaura Harmit author non-byline.; Bandyopadhyay Soham author non-byline.; Lakhoo Kokila author non-byline.; Etchill Eric W author non-byline.; Rhee Daniel author non-byline.; Cooper Stacy author non-byline.; Crow Kevin author non-byline.; Drucker Morgan author non-byline.; Murphy Megan author non-byline.; Shou Benjamin author non-byline.; Siegel Alan author non-byline.; Kara Yasin author non-byline.; Özdemir Gül Nihal author non-byline.; Elfiky Mahmoud author non-byline.; Refaee Ehab El author non-byline.; Massoud John George author non-byline.; Ibrahim Ayah Bassam author non-byline.; Ibrahim Ruaa Bassam author non-byline.; Za'nouneh Faris Abu author non-byline.; Baddourah Ranya M. author non-byline.; Fahmawee Toqa author non-byline.; Al_Shraideh Ayah author non-byline.; Salman Ghazwani author non-byline.; Alameer Ehab author non-byline.; Ali Al-Mudeer author non-byline.; Yahia Ghazwani author non-byline.; Waleed Khozairi author non-byline.; Abou Chaar Mohamad K. author non-byline.; Sultan Iyad author non-byline.; Ghandour Khalil author non-byline.; Al-Dabaibeh Shaima' author non-byline.; 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• Is Part Of: BMJ open. Volume 12:Issue 4(2022)
• Publication Date: 2022-04-11
• Subjects: paediatric oncology -- paediatrics -- public health; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-054690
• Languages: English
• ISSNs: 2044-6055

Abstract

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.