The COVID-19 pandemic and pediatric cancer at Oslo University Hospital

Background
On March 13th 2020 the Norwegian society was to a large extent shut down to prevent the spread of the new SARS-COV2 virus and its disease COVID-19; all schools and day cares were closed, travelers from abroad were put in 2 weeks quarantine, social distancing of 2 meters was recommended, and groups of maximum 5 people were allowed. Simultaneously, there was great focus on personal hygiene recommendations. Gradually, from the end of April, the implementations were lifted and society stepped closer to normality.
All new cancer cases in patients <18 years in the South-Eastern region of Norway are admitted and diagnosed at Oslo University Hospital (OUH) and a clinical pathway for cancer in children is started. The effects of the SARS-COV-2 virus and the weeks of lock-down in society on children with cancer were unknown. Infectious disease is often the main reason for children to contact the health services. From March 2020 there has been a reduction in commonly occurring infectious disease in the population due to social distancing and increased focus on hygiene, and patients exhibiting symptoms of fever or respiratory infection have been advised to stay home. A report from 6 institutions in the Lombardia region in Italy found a 50% reduction in new cancer cases in children during the first 8 weeks of the COVID19 pandemic (1). Similarly, after the SARS-epidemic in Hong Kong in 2003, which also lead to a lock-down of society with increased focus on social distancing and hygiene, they found a decrease in new ALL cases in young children (2).
We have not had children under treatment for cancer hospitalized with COVID-19 at OUH, but we suspect that fewer children have been diagnosed with cancer in the period March-June 2020.
Methods:

  • Review clinical pathways for cancer in children started from 01.01.2017–30.06.2020 at OUH and that resulted in a cancer diagnosis. Compare trends over months and look at cancer subgroups (leukemias and solid tumors within or outside the central nervous system).
  • Reviewed outpatient consultations and cancellations at the pediatric hematology and oncology clinic at OUH during the first 6 months of 2020 compared to the first 6 months of 2019.
  • Review all airborne infectious pathogens found in children <18 at the microbiology department of OUH during 2020 compared to previous years.

Plan:
This is a retrospective quality study to look at the effect of the society measures implemented to reduce the spread of SARS-COV-2 on the diagnosis of new pediatric cancer patients at OUH and on follow up at the outpatient clinic for pediatric oncology and hematology at OUH in the first 3 months after the virus came to Norway and society was shut down. We plan to publish the data.

References

  1. Ferrari A, Zecca M, Rizzari C, Porta F, Provenzi M, Marinoni M, et al. Children with cancer in the time of COVID-19: An 8-week report from the six pediatric onco-hematology centers in Lombardia, Italy. Pediatr Blood Cancer. 2020:e28410.
  2. Li CK, Zee B, Lee J, Chik KW, Ha SY, Lee V. Impact of SARS on development of childhood acute lymphoblastic leukaemia. Leukemia. 2007;21(7):1353-6.

Project leader:

Ellen Ruud

 
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