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CIDRAP- Adult childhood cancer survivors at 58% higher risk for severe COVID, report suggests

Lance

MPH, CSP & CIT Retired, CHMM Emeritus
https://www.cidrap.umn.edu/covid-19...s-58-higher-risk-severe-covid-report-suggests

Adult childhood cancer survivors at 58% higher risk for severe COVID, report suggests



Mary Van Beusekom, MS


Today at 3:06 p.m.

COVID-19
Adult survivors of childhood cancer may remain at elevated risk for severe COVID-19 for decades after their cancer diagnosis, a Karolinska Institutet-led research team writes in The Lancet Regional Health–Europe.

The study, published late last week, used Danish and Swedish registry data to compare rates of COVID-19 infection and severe cases among 13,659 childhood cancer survivors diagnosed before age 20 with those of their 17,531 siblings and 58,803 community controls from 2020 through 2022. All participants were at least 20 years old when the pandemic began, with an average age of about 41 at study enrollment.

Advanced diagnostic tests and progress in the treatment of childhood cancers have improved survival substantially, with 5-year-survival exceeding 85% in high-income countries, the study authors noted. "However, these survivors represent a vulnerable group, with a markedly higher risk of chronic health conditions and premature mortality compared to the general population," they wrote.

Risk higher in Sweden than Denmark


While childhood cancer survivors were at lower risk for COVID-19 infection than controls (adjusted hazard ratio [aHR], 0.91), they were at higher risk for severe outcomes (hospitalization, intensive care unit admission, or death) if they were infected (aHR, 1.58).

Stratified analyses revealed a notable increase in risk among cancer survivors aged 50 years or older at baseline (aHR, 1.85), survivors of solid tumors (aHR, 1.63), and those who received a cancer diagnosis at age 15 years or older (aHR, 2.28).

Our results suggest that childhood cancer survivors should be considered a risk group in future pandemics or other health crises.

Javier Louro, PhD

The risk of severe outcomes was especially pronounced during periods of widespread community spread, such as at the beginning of the pandemic and after the emergence of highly transmissible variants like Alpha in 2020 and Omicron in 2021.

The risk was also higher among those who lived in Sweden (aHR, 1.65), which relied on disease-mitigation recommendations and limited school closures rather than the early and stringent restrictions (eg, lockdowns, school closures) implemented in Denmark and elsewhere in Europe.

The researchers cautioned that the results may not be generalizable to other countries because of potential differences in healthcare access and public health responses.

"Our results suggest that childhood cancer survivors should be considered a risk group in future pandemics or other health crises," lead author Javier Louro, PhD, said in a Karolinska Institutet press release. "This could involve prioritising them for vaccination or offering special protection during periods of high transmission."
 
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