BMJ Global Health (Oct 2022)

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

  • Md Hasanuzzaman,
  • Mohamed Ahmed,
  • Ahmed Samir,
  • Charlotte Smith,
  • Lubna Samad,
  • Vaishnavi Govind,
  • Fakher Rahim,
  • Ahmed Moussa,
  • Adesoji O Ademuyiwa,
  • Bobby John,
  • Augusto Zani,
  • Vivek Singh,
  • Muhammad Arshad,
  • Sadaf Altaf,
  • Chan Hon Chui,
  • Pooja Kumari,
  • Thomas Smith,
  • Ayesha Saleem,
  • Matthew HV Byrne,
  • Madhivanan Karthigeyan,
  • Pravin Salunke,
  • Darica Au,
  • Kate Cross,
  • Kokila Lakhoo,
  • Vishal Kumar,
  • Anna Maria Testi,
  • Robyn Brown,
  • Noel Peter,
  • Georgios Tsoulfas,
  • Francesco Pata,
  • Adesoji Ademuyiwa,
  • Tahmina Banu,
  • Bruce Bvulani,
  • Milind Chitnis,
  • Maryam Ghavami Adel,
  • Vrisha Madhuri,
  • Pierfrancesco Lapolla,
  • Andrea Mingoli,
  • Hamidah Alias,
  • Simone de Campos Vieira Abib,
  • Ibukunolu Olufemi Ogundele,
  • Felix M Alakaloko,
  • Emmanuel A Ameh,
  • Laila Hessissen,
  • Kareem O Musa,
  • Georgios Karagiannidis,
  • Manoj Gupta,
  • Maricarmen Olivos,
  • Daniel Rhee,
  • Maryam Khan,
  • Christine Nitschke,
  • Alexandra Valetopoulou,
  • Ashrarur Rahman Mitul,
  • Sabbir Karim,
  • Mahmoud M Saad,
  • Francis Abantanga,
  • Gaetano Gallo,
  • Mohamedraed Elshami,
  • Mahmoud Elfiky,
  • Soham Bandyopadhyay,
  • Muath Alser,
  • Elliott H Taylor,
  • Duha Jasim,
  • Somy Charuvila,
  • Nazmul Islam,
  • William B Lo,
  • Uttam Kumar Nath,
  • Robin Simpson,
  • Zarina Abdul Latiff,
  • Bruno Cirillo,
  • Gioia Brachini,
  • Megan Murphy,
  • Zineb Bentounsi,
  • Anette S Jacobsen,
  • Anna Casey,
  • Mohammed Alhendy,
  • Taiwo Akeem Lawal,
  • Samson Olori,
  • Michael Boettcher,
  • Muhammed Elhadi,
  • Shaun Wilson,
  • Dragana Janić,
  • Amit Sehrawat,
  • Patricia Shinondo,
  • Shireen Anne Nah,
  • Alhassan Abdul-Mumin,
  • Karl-Heinz Frosch,
  • Poorvaprabha Patil,
  • Sarah Muma,
  • Md Asaduzzaman,
  • Athanasios Tragiannidis,
  • Vijayendra Kumar,
  • Mahan Salehi,
  • Sara Ali,
  • Renu Madan,
  • Hafeez Abdelhafeez,
  • Max Pachl,
  • Benjamin Martin,
  • Sonal Nagras,
  • Mihir Sheth,
  • Catherine Dominic,
  • Suraj Gandhi,
  • Divya Parwani,
  • Rhea Raj,
  • Diella Munezero,
  • Rohini Dutta,
  • Nsimire Mulanga Roseline,
  • Kellie McClafferty,
  • Armin Nazari,
  • Smrithi Sriram,
  • Sai Pillarisetti,
  • King-David Nweze,
  • Aishwarya Ashwinee,
  • Gul Kalra,
  • Priyansh Nathani,
  • Khushman Kaur Bhullar,
  • Nehal Rahim,
  • Shweta Madhusudanan,
  • Joshua Erhabor,
  • Manasi Shirke,
  • Aishah Mughal,
  • Sravani Royyuru,
  • Syeda Namayah Fatima Hussain,
  • Daniel Robinson,
  • Mehdi Khan,
  • Alexandre Dukundane,
  • Kwizera Festus,
  • Rohan Pancharatnam,
  • Lorraine Ochieng,
  • Hritik Nautiyal,
  • Leanne Gentle,
  • Ehab Hanafy,
  • Catherine Yang,
  • Gideon Karplus,
  • John Mathew,
  • Olumide Abiodun Elebute,
  • Oluwaseun Ladipo-Ajayi,
  • Okechukwu Hyginus Ekwunife,
  • Sherief Ghozy,
  • Emily Hamilton,
  • Dhruva Ghosh,
  • Ahmed Sherif,
  • Hajar Moujtahid,
  • Ariana Axiaq,
  • Amir Labib,
  • Eman Abdulwahed,
  • Kemal Tolga Saracoglu,
  • Yasin Kara,
  • Ahmed Y Azzam,
  • Omar Elmandouh,
  • Manjul Tripathi,
  • Abdelrahman Azzam,
  • Anfel Bouderbala,
  • Aouabed Nesrine,
  • Ammar Ayman,
  • Mohamed Bonna,
  • Safia Lorabi,
  • Hira Zuberi,
  • Iyad Sultan,
  • Reto M Baertschiger,
  • Kefas John Bwala,
  • AM Umar,
  • Abdurahaman Aremu,
  • Dauda E Suleiman,
  • Tybat Aliyu,
  • Kashaf Turk,
  • Oluseyi Oyebode Ogunsua,
  • Tunde Talib Sholadoye,
  • Musliu Adetola Tolani,
  • Yakubu Alfa,
  • Keffi Mubarak Musa,
  • Ken Muma,
  • Mitchelle Obat,
  • Youssef Sameh Badran,
  • Abdulrahman Ghassan Qasem,
  • Faris Ayasra,
  • Reema Alnajjar,
  • Mohamed Abdel-Maboud,
  • Abdelrahman Bahaa,
  • Ayat M Saadeldin,
  • Mohamed Adwi,
  • Mahmoud Adly,
  • Abdallah Elshenawy,
  • Amer Harky,
  • Kirstie Wright,
  • Jessica Luyt,
  • Olivia White,
  • Nathan Thompson,
  • Imogen Harrison,
  • Sara Kader Alsaeiti,
  • Fatma Saleh Benkhial,
  • Hend Mohammed Masoud,
  • Mabroukah Saeid Alshamikh,
  • Fatma Mohammed Masoud,
  • Nyararai Togarepi,
  • Elaine Carrolan,
  • Ahmed Saleh,
  • Mahmoud Bassiony,
  • Mostafa Qatora,
  • Mohamed Bahaaeldin,
  • Shady Fadel,
  • Yasmine El Chazli,
  • Kamel Hamizi,
  • Mehdi Anouar Zekkour,
  • Rima Rahmoun,
  • Boutheyna Drid,
  • Salma Naje Abu Teir,
  • Mohamed Yazid Kadir,
  • Yassine Zerizer,
  • Nacer Khernane,
  • Brahim Saada,
  • Imane Ammouze,
  • Yahya Elkaoune,
  • Ghita Chaoui,
  • Hajar Benaouda,
  • Meryem Gounni,
  • Narjiss Aji,
  • Joana Mafalda Monteiro,
  • Susana Nunes,
  • Maria do Bom-Sucesso,
  • Kerri Becktell,
  • Md Afruzul Alam,
  • Orindom Shing Pulock,
  • Tasmiah Tahera Aziz,
  • Rosanda Ilic,
  • Danica Grujicic,
  • Tijana Nastasovic,
  • Igor Lazic,
  • Mihailo Milicevic,
  • Vladimir Bascarevic,
  • Radovan Mijalcic,
  • Vuk Scepanovic,
  • Aleksandar Stanimirovic,
  • Aleksandra Paunovic,
  • Ivan Bogdanovic,
  • Shahnoor Islam,
  • AKM Amirul Morshed,
  • Mehnaz Akter,
  • Zannat Ara,
  • Mohammed Tanvir Ahammed,
  • Tania Akter,
  • Kamrun Nahar,
  • Fatema Sayed,
  • Ashfaque Nabi,
  • Elif Akova,
  • Evren Aydogmus,
  • Bekir Can Kendirlioglu,
  • Tufan Hicdonmez,
  • Asim Noor Rana,
  • Mohammed A Azab,
  • Alzhraa Salah Abbas,
  • Olanrewaju Moses,
  • Ibiyeye Taiye Taibat,
  • Taiwo Jones,
  • Kalu Ukoha,
  • Olagundoye Goke,
  • Okorie Ikechukwu,
  • Abiodun Idowu Okunlola,
  • Helga Nauhaus,
  • Danelle Erwee,
  • Agata Chylinska,
  • Prasanna Gomes,
  • Elvercio Pereira de Oliveira Junior,
  • Fabiola Leonelli Diz,
  • Mohamed El Kassas,
  • Usama Eldaly,
  • Ahmed Tawheed,
  • Mohamed Abdelwahab,
  • Oudrhiri Mohammed Yassaad,
  • Bechri Hajar,
  • El Ouahabi Abdessamad,
  • Arkha Yasser,
  • Hessissen Laila,
  • Farah Sameer Yahya,
  • Maria Teresa Peña Gallardo,
  • Jacqueline Elizabeth Montoya Vásquez,
  • Juan Luis García León,
  • Sebastián Shu Yip,
  • Mariam Lami,
  • Harmit Ghattaura,
  • Eric W Etchill,
  • Stacy Cooper,
  • Kevin Crow,
  • Morgan Drucker,
  • Benjamin Shou,
  • Alan Siegel,
  • Gül Nihal Özdemir,
  • Ehab El Refaee,
  • John George Massoud,
  • Ayah Bassam Ibrahim,
  • Ruaa Bassam Ibrahim,
  • Faris Abu Za'nouneh,
  • Toqa Fahmawee,
  • Ghazwani Salman,
  • Ehab Alameer,
  • Al-Mudeer Ali,
  • Ghazwani Yahia,
  • Khozairi Waleed,
  • Khalil Ghandour,
  • Shaima' Al-Dabaibeh,
  • Ammar Al-Basiti,
  • Hazim Ababneh,
  • Omaima El-Qurneh,
  • Yousef Alalawi,
  • Ahmad Al Ayed,
  • Naif Al Bolowi,
  • Heidi Barola,
  • Aubrey L Pagaduan,
  • Jingdan Fan,
  • Olufemi Oni,
  • Janita Zarrish,
  • Ramsha Saleem,
  • Soha Zahid,
  • Atiqa Amirali,
  • Ahsan Nadeem,
  • Sameer Saleem Tebha,
  • Zonaira Qayyum,
  • Sana Tahir,
  • Anneqa Tahir,
  • Rabbey Raza Khan,
  • Ayesha Mehmood,
  • Taimur Iftikhar Qureshi,
  • Victor Calvagna,
  • Nathalie Galea,
  • Matthew R Schuelke,
  • Kirk David Wyatt,
  • Agnes Vojcek,
  • Seham M Ragab,
  • Abdallah R Allam,
  • Eman Ibrahim Hager,
  • Kıvılcım Karadeniz Cerit,
  • Adnan Dağçınar,
  • Tümay Umuroğlu,
  • Ayten Saraçoğlu,
  • Mustafa Sakar,
  • Can Kıvrak,
  • Gül Çakmak,
  • Ibrahim Sallam,
  • Gamal Amira,
  • Mohamed Sherief,
  • Arissa Ikeda,
  • Licia Portela,
  • Marianne Monteiro Garrigo,
  • Fernanda Lobo,
  • Sima Ester Ferman,
  • Andrew Nwankwo Osuigwe,
  • Chisom Adaobi Nri-Ezedi,
  • Eric Okechukwu Umeh,
  • Abiodun Folashade Adekanmbi,
  • Olubunmi Motunrayo Fatungase,
  • Olubunmi Obafemi Obadaini,
  • Sarah Al-Furais,
  • Humaida Hemlae,
  • Sreylis Nay,
  • Fabianne Altruda de Moraes Costa Carlesse,
  • Denis Cozzi,
  • Paolo Musiu,
  • Paolo Sapienza,
  • Martina Zambon,
  • Simona Meneghini,
  • Pierfranco Cicerchia,
  • Abdulrahman Omar Taha,
  • Bouaoud Souad,
  • Mebarki Malika,
  • Bioud Belkacem,
  • Fayza Haider,
  • Halwani Yaninga Fuseini,
  • Peter Gyamfi Kwarteng,
  • Abubakari Bawa Abdulai,
  • Sheba Mary Pognaa Kunfah,
  • Stephanie Ajinkpang,
  • Mary Joan Kpiniong,
  • Kingsley Aseye Hattor,
  • Kingsley Appiah Bimpong,
  • Mohamed Elbahnasawy,
  • Sherief Abdelsalam,
  • Amanpreet Brar,
  • Andreea C Matei,
  • Hira Khalid Zuberi,
  • Kishwer Nadeem,
  • Naema Khayyam,
  • Fatima Ambreen Imran,
  • Nida Zia,
  • Sadia Muhammad,
  • Muhammad Rafie Raza,
  • Muhammad Rahil Khan,
  • Alaa Hamdan,
  • Abdeljawad Mazloum,
  • Ali Abodest,
  • Nisreen Ali,
  • Ammar Omran,
  • Alaa Ahmed,
  • Munawar Hraib,
  • Victor Khoury,
  • Abdulrahman Almjersah,
  • Mohammad Ali Deeb,
  • Akram Ahmed,
  • Ahmad Bouhuwaish,
  • Alqasim Abdulkarim,
  • Marwa Biala,
  • Reem Ghamgh,
  • Amani Alamre,
  • Marwa Shelft,
  • Hoda Tawel,
  • Emmanuel Hatzipantelis,
  • Eleni Tsotridou,
  • Assimina Galli-Tsinopoulou,
  • C-Khai Loh,
  • Doris Lau,
  • Kelvin Ifeanyichukwu Egbuchulem,
  • Olakayode Olaolu Ogundoyin,
  • Isaac Dare Olulana,
  • Oluwasegun Joshua Afolaranmi,
  • AbdulBasit Fehintola,
  • Annika Heuer,
  • Matthias Priemel,
  • Lennart Viezens,
  • Martin Stangenberg,
  • Marc Dreimann,
  • Alonja Reiter,
  • Jasmin Meyer,
  • Leon Köpke,
  • Uduak Offiong,
  • Philip Mari Mshelbwala,
  • Fashie Andrew Patrick,
  • Aminu Muhammed Umar,
  • N Otene ThankGod,
  • Yuki Julius Ng,
  • Syukri Ahmad Zubaidi,
  • Murad Almasri,
  • Rasaq Olaosebikan,
  • Akila Muthukumar,
  • Amon Ngongola,
  • Azad Patel,
  • Abdullahi Nuhu-Koko,
  • Baba Jibrin,
  • Gabriela Guillén,
  • Sergio López,
  • José Andrés Molino,
  • Pablo Velasco,
  • Omar Hamam,
  • Rim Elmandouh,
  • Nensi Melissa Ruzgar,
  • Rachel Levinson,
  • Shashwat Kala,
  • Sarah Ullrich,
  • Emily Christison-Lagay,
  • Janice Hui Ling Wong,
  • Reto Baertschiger,
  • Essam Elhalaby,
  • Guido Seitz,
  • Judith Lindbert,
  • Asimina Galli-Tsinopoulou,
  • Calogero Virgone,
  • Eric Mwangi Irungu,
  • Outani Oumaima,
  • Lily Saldana,
  • Jan Godzinsky,
  • Abdelbasit Ali,
  • Mohamed Bella Jalloh,
  • Nellie Bell,
  • Annette Jacobsen,
  • Israel Fernandez Pineda,
  • Lucas Krauel,
  • Waha Rahama,
  • Hazim Elfatih,
  • Arda Isik,
  • Andrea Hayes-Jordan,
  • Roshni Dasgupta,
  • Krishna Kumar Govindarajan,
  • Marta deAndres Crespo,
  • Nitin James Peters,
  • Santosh Kumar Mahalik,
  • Rajat Piplani,
  • Enono Yhoshu,
  • K S Rajkumar,
  • Sadi A Abukhalaf,
  • Mohammed Miftah Faraj Almihashhish,
  • Eman Salem Muftah Burzeiza,
  • Raja Mari Mohammed Nasef,
  • Benjamin J O'Sullivan,
  • Mohamed Hassanin,
  • Dave R Lal,
  • Brian T Craig,
  • Vishal Michael,
  • M Joseph John,
  • William Bhatti,
  • Swati Daniel,
  • Jyoti Dhiman,
  • Hunar Mahal,
  • Atul Suroy,
  • Shruti Kakkar,
  • Shaina Kamboj,
  • Suraj Singh,
  • AKM Khairul Basher,
  • SM Rezanur Rahman,
  • Md Asif Iqbal,
  • Md Masud Rana,
  • Monica Dobs,
  • Mohamed Atef Mohamed Ghamry,
  • Joana Monteiro,
  • Marco Aurelio Ciriaco Padilha,
  • Lucas Garschagen deCarvalho,
  • Sandip Kumar Rahul,
  • Digamber Chaubey,
  • Rejin Kebudi,
  • Sema Bay Buyukkapu,
  • Kumaravel Sambandan,
  • Smita Kayal,
  • Gunaseelan Karunanithi,
  • Bikash Kumar Naredi,
  • Bibekanand Jindal,
  • Ranya M Baddourah,
  • Ayah Al Shraideh,
  • Ahmad Ozair,
  • Ankur Bajaj,
  • Bal Krishna Ojha,
  • Kaushal Kishor Singh,
  • Atique Anwar,
  • Vinay Suresh,
  • Mohamad K Abou Chaar,
  • Christopher O Bode,
  • Justina O Seyi-Olajide,
  • George C Ihediwa,
  • Edamisan O Temiye,
  • Adeseye M Akinsete,
  • Iqra Effendi,
  • Khaled Mamdouh,
  • Mohamed Atef,
  • Mohamed Faried,
  • Jake A Kloeber,
  • Robert L Owen,
  • Alexander S Roth,
  • J Hudson Barnett,
  • Lucien P Jay,
  • Paul J Galardy,
  • Bernard Mbwele,
  • Irene Nguma,
  • Moshi Moshi Shabani,
  • Amani Twaha,
  • Bilal Matola,
  • Mahmoud Maher Abdelnaby Alrahawy,
  • Simone deOliveira Coelho,
  • Ricardo Vianna deCarvalho,
  • FernandaFerreira daSilva Lima,
  • Moawia Mohammed AliElhassan,
  • Nada Osman Yousif Elhaj,
  • Hytham KS Hamid,
  • Vincent E Nwatah,
  • Adewumi B Oyesakin,
  • RM Jeffri Ismail,
  • Simone deCamposVieira Abib,
  • Mayara Caroline Amorim Fanelli,
  • Fernanda Kelly Marques de Souza,
  • Sandeep Mohindra,
  • Ninad R Patil,
  • Richa Jain,
  • Gopal Nambi,
  • Norehan Johari,
  • Anas Shikha,
  • Win SabaiPhyu Han,
  • Zahidah Ahmad,
  • Yen Yan Lim,
  • Roserahayu Idros,
  • Noorainun Mohd Yusof,
  • David Nelson Jaisingh,
  • Fatema Naser AlFayez,
  • Elana Kleinman,
  • Taylor Ibelli,
  • Rochelle Fayngor,
  • Tzvi Najman,
  • Etai Adam,
  • Daniella Melamed,
  • Cecilia Paasche,
  • Farman Ali Laghari,
  • Zainab Al Balushi,
  • Abdulhakim Awadh SalimAl-Rawas,
  • Ali Al Sharqi,
  • Ammar Saif AlShabibi,
  • Ismail Al Bulushi,
  • Muna Alshahri,
  • Abdulrahman AlMirza,
  • Ola Al Hamadani,
  • Jawaher Al Sharqi,
  • Anisa Al Shamsi,
  • Bashar Dawud,
  • Sareya Al Sibai,
  • Gilbert B Bonsaana,
  • Edmund M Der,
  • Francis A Abantanga,
  • Bardisan Gawrieh,
  • Hassan Salloum,
  • Mohammad Ahmad Almahmod Alkhalil,
  • Waseem Shater,
  • Ali Farid Alelayan,
  • Alaa Guzlan,
  • Asmaa AM Albanna,
  • Dayang AnitaAbdul Aziz,
  • Azrina Syarizad Khutubul Zaman,
  • Biobele J Brown,
  • Ajiboye L Olalekan,
  • Christopher S Lukong,
  • Ezekiel I Ajayi,
  • Luca Pio,
  • Nitin James Peter,
  • Ravi Kishore,
  • Mohammad K Abou Chaar,
  • Dayang Anita Abdul Aziz,
  • Dhruva Nath Ghosh,
  • Raphael N Vuille-dit-Bille

DOI
https://doi.org/10.1136/bmjgh-2022-008797
Journal volume & issue
Vol. 7, no. 10

Abstract

Read online

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality.Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months.Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3–11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality.Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer.