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Adolescents and young adults with cancer: the clinical course of COVID-19 infections
Julie A Wolfson1,2, Elizabeth S Davis3, Aniket Saha4
1Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Journal of the National Cancer Institute
|April 16, 2024
Summary
COVID-19 outcomes in adolescents and young adults (AYAs) with cancer varied by age. Older AYAs had fewer hospitalizations but more cancer treatment changes, while unvaccinated patients faced higher ICU admission odds.
Area of Science:
- Oncology
- Infectious Diseases
- Public Health
Background:
- Adolescents and young adults (AYAs) aged 15-39 years with cancer are a vulnerable population underrepresented in clinical trials and COVID-19 registries.
- Understanding the clinical course of COVID-19 in AYAs with cancer is crucial for effective management and prevention strategies.
Purpose of the Study:
- To examine the clinical course of COVID-19 among AYAs with cancer using data from the Pediatric Oncology COVID-19 Case Report.
- To identify age-related differences in COVID-19 severity and treatment modifications within the AYA cancer population.
Main Methods:
- Utilized the Pediatric Oncology COVID-19 Case Report, collecting deidentified data from over 100 institutions.
- Analyzed data from 191 older AYAs (22-39 years) and 640 younger AYAs (15-21 years) diagnosed with cancer and COVID-19 between April 2020 and November 2023.
- Performed multivariable analyses to assess factors influencing hospitalization, ICU admission, respiratory support, and changes to cancer-directed therapy.
Main Results:
- Older AYAs experienced significantly lower rates of hospitalization (P < .001) and ICU admission (P = .02) compared to younger AYAs.
- Older AYAs had 80% lower odds of ICU admission but 2.3 times greater odds of requiring changes to cancer-directed therapy.
- Unvaccinated patients with cancer had 5.4 times higher odds of ICU admission.
Conclusions:
- The clinical course of COVID-19 in AYAs with cancer is influenced by age, with distinct patterns observed between older and younger individuals.
- Age-specific findings highlight the need for tailored COVID-19 management and prevention approaches for AYAs undergoing cancer treatment.
- Vaccination status is a critical factor in mitigating severe COVID-19 outcomes, including ICU admission, among AYAs with cancer.
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