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\begin{document}

\title{COVID-19 Management and Outcome of 76 Pediatric Cancer Patients: A
Single Centre Experience from a Developing Country}



\author[1]{Mahmoud Hammad}%
\author[1]{lobna shalaby}%
\author[1]{Iman Sidhom}%
\author[2]{Nancy Sherif}%
\author[2]{Ibrahim Abdo}%
\author[1]{Sonya Soliman}%
\author[1]{Youssef Madney}%
\author[3]{Reem Hassan}%
\author[2]{Shaimaa Elmeniawy}%
\author[2]{Nagwa Khamis}%
\author[1]{Iman  zaki}%
\author[1]{Tarek Mansour }%
\author[3]{Mohamed  El-Ansary}%
\author[3]{Ahmed  El-Halfawy }%
\author[1]{Sherif Abouelnaga}%
\author[1]{Alaa Elhaddad}%
\affil[1]{National Cancer Institute Cairo University}%
\affil[2]{Children's Cancer Hospital Egypt 57357}%
\affil[3]{Cairo University Kasr Alainy  Faculty of Medicine}%


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  \date{May 22, 2024}


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\begin{abstract}
Background: Sufficient data pertaining to the impact of the COVID-19
pandemic on pediatric cancer patients is still currently lacking. The
main aim of this prospective study was to describe clinical management
and outcomes of COVID-19 in this vulnerable group. Methods: Conducted
between May 1st and November 30, 2020, this study included 76 pediatric
oncology patients with confirmed COVID-19. Remdesivir (RDV) was the
antiviral therapy used. Results: The median age of patients was 9 years.
Sixty patients were on first line treatment. Haematological malignancies
constituted 86.8\% of patients. 35.4\% of cases had severe to critical
infections. The commonest presentation was fever (93.4\%). Chemotherapy
was delayed in 59.2\% of cases and doses were modified in 30.2\%. The
sixty-day overall survival (OS) stood at 86.6\%, with mortalities
occurring only among critically ill patients. Of sixteen acute leukaemia
patients in the first induction phase of treatment, 13 survived and 10
achieved induction remission. A negative PCR within 2 weeks and
improvement of radiological findings were statistically related to
disease severity (p=0.008 and, 0.002 respectively). Better OS was
associated with regression of radiological findings after 30 days from
infection (p=0.002). Of the forty-five cases who received RDV, 70\% were
severe to critically ill cases with comparable outcome to patients who
did not receive the drug. Conclusions: Most pediatric cancer patients
with COVID-19 should have good clinical outcomes, except for those with
critical form of infections. Newly diagnosed cases seem to tolerate
induction therapy alongside COVID-19 treatment. RDV was well tolerated
with no serious adverse events observed.%
\end{abstract}%



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