Clinical characteristics and evolution of pediatric patients with acute leukemia and SAR-COV2 virus infection in a third level hospital in Mexico

Jara, Berenice Sánchez; Torres Jimenez, Alfonso Ragnar; Martínez, María de los Angles del Campo; Ortíz Torres, María Guadalupe; Soto, Angel García; Santiaguillo, Paloma del Rocío Loza; Aguilar Olvera, Dulce María; Pérez Casillas, Ruy Xavier; Herver Olivares, Annecy Nelly; Reynoso Arenas, Perla Verónica; Vega Rojas, Alicia Montserrat; Fuentes Santana, Diana Guadalupe; Huitron Salazar, Edna Sarahi

Introduction Reports have revealed that people susceptible to severe forms of COVID-19 are older adults with comorbidities; However, the pediatric population has also been affected, considering children with underlying conditions such as onco-hematological conditions to be high risk. We present a cases series in a third level hospital. Material and methods We conducted a retrospective study in children under the age of 16 years with a diagnosis of acute leukemia and infection with the SARS-CoV2 virus. Descriptive statistics with means and percentages were used. To show differences between the groups, Chi-square test, Student t test and Mann-Whitney U test were used depending on the type of variable and its distribution. Results SARS-CoV2 virus infection was confirmed in 15 children diagnosed with acute leukemia, at different stages of treatment. The mean age was 7.5 years, 8 male and 7 female, 11 of them diagnosed with acute B-cell lymphoblastic leukemia, one with acute T-cell lymphoblastic leukemia and 3 with acute myeloid leukemia. The mean days of hospital stay at the diagnosis of COVID-19 was 22. Thirteen of the children had fever and neutropenia. 7 patients died. There was a statistically significant correlation with the outcome in patients who presented a prolongation of aPTT, an increase in D-dimer, an increase in liver enzymes and severe respiratory distress with the need for mechanical ventilation. Conclusion The risk of death in children with leukemia and COVID-19 was associated with prolonged aPTT, increased D-dimer, increased liver enzymes, respiratory distress, and the need for mechanical ventilation.