Observational studyBMJ open2022
Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study.
Observational study in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 29 citations in OpenAlex.
- Global burden of acute lymphoblastic leukemia following the COVID-19 pandemic.Annals of hematology · 2025Article
- Impact of the COVID-19 pandemic on diagnosis and management of new brain tumours in children and young people (aged < 16 years old) in the UK.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Observational
- Retinoblastoma programme outcome over a 10-year period in Lebanon: assessment of potential impact of the pandemic and economic crisis.Eye (London, England) · 2025Article
- Contemporary epidemiological landscape of pediatric non-Hodgkin lymphoma: a global burden of disease analysis.Frontiers in oncology · 2025Article
- Impact of the COVID-19 Pandemic Onset on the Early Careers of Pediatric Oncology Health Professionals and Researchers: A Report From the Children's Oncology Group Young Investigators Committee, Young SIOP Network, and Young SIOPE.Pediatric blood & cancer · 2025Article
- Epidemiological trends and treatment abandonment of paediatric solid tumours in a nigerian tertiary hospital: a seven-year review (2016-2022).BMC cancer · 2024Article
- Impact of the COVID-19 pandemic in childhood and adolescent cancer care in northern Tanzania: a cross-sectional study.BMC cancer · 2024Article
- COVID-19 in Pediatric Patients With Acute Lymphoblastic Leukemia or Lymphoma.JAMA network open · 2024Article
- Incidence of bacterial and fungal infections in Polish pediatric patients with acute lymphoblastic leukemia during the pandemic.Scientific reports · 2023Article
- Readmission rates and outcomes in adults with and without COVID-19 following inpatient chemotherapy admission: A nationwide analysis.World journal of clinical oncology · 2023Article
- Impact of the COVID-19 pandemic on paediatric renal tumour presentation and management, a SIOP renal tumour study group study.Cancer medicine · 2023Article
- Telemedicine in Care of Sarcoma Patients beyond the COVID-19 Pandemic: Challenges and Opportunities.Cancers · 2023Review
- Impact of the COVID-19 on the surgical management of bone and soft tissue sarcoma: A systematic review.Journal of orthopaedics · 2023Review
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPaediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs.
designA multicentre, international, collaborative cohort study.
setting91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020.
participantsPatients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer.
main outcome measureAll-cause mortality at 30 days and 90 days.
results1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001).
conclusionsThe COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally.
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