Children with cancer are not at higher COVID-19 infection risk: Study

Children with cancer are no more vulnerable than other children to COVID-19 infection or morbidity resulting from the disease, according to a study. The study, published in JAMA Oncology, found that of all the children with cancer infected with COVID-19, 95 percent had mild symptoms, and did not require hospitalization.

The researchers from Memorial Sloan Kettering Cancer Center (MSK) in the US also tested asymptomatic children with cancer, finding only a 2.5 percent rate of positivity compared to nearly 15 percent in their adult caregivers. Only half of the children with COVID-19 positive caregivers were themselves also COVID-19 positive, the researchers said. The team also found very significant sex skewing with the vast majority of COVID-19 infections occurring in males.

These results suggest that children with cancer are not more susceptible than other children to infection or symptoms resulting from COVID-19 and that children are not an unrecognized reservoir of asymptomatic COVID-19 infection. From March 10 through April 12, 2020, the researchers instituted a screening and testing plan to mitigate risk associated with infection with COVID-19.

The patients were screened for exposure to contacts with known COVID-19 infection or for the presence of symptoms of COVID-19 illness at MSK. The researchers performed COVID-19 testing on pediatric patients and their adult caregivers.

Of the 178 unique pediatric cancer patients tested, the rate of positivity for COVID-19 was 29.3 percent in children with symptoms, but only 2.5 percent in asymptomatic children. Of the 20 patients who tested positive for COVID-19, only 3 were female, the researchers said.

Only one patient with COVID-19 illness required non-critical care hospitalization for associated symptoms of the disease. All other pediatric patients had mild disease symptoms and were managed at home, according to the researchers.

Of the 74 tested, 13 adult caregivers of 10 patients were found to be positive for COVID-19, including a 14.7 percent rate of COVID-19 infection in asymptomatic caregivers, they said. Only half of the patients with COVID-19 positive caregivers were themselves also COVID-19 positive, suggesting low infectivity in children despite close household contacts.