Ersin TÖRET, Uğur TOKDEMİR, Zeynep Canan ÖZDEMİR, Berra Nur AKSAKAL, Ömer KILIÇ, Tercan US, Gül DURMAZ, Ozcan BOR

COVID-19 pandemisi öncesi kanserli çocukların akut solunum yolu viral enfeksiyonlarının epidemiyolojisi

COVID-19 pandemisi sırasında kanserli çocuklar yüksek riskli gruplardan biri oldular. Hastaların kolay vegüvenli hasta bakımına, daha önemlisi tedaviye ulaşması tüm dünyada zorlaştı. Pandemi nedeniyle sağlık hizmetlerine sınırlı erişim ve ebeveynlerin çocuklarındaki semptomların erken tıbbi değerlendirilmesini engelleyen COVID-19 korkusu birçok çocukluk çağı kanserinin geç teşhisine neden oldu. Akut solunum yolu enfeksiyonları, COVID-19 pandemisinden bağımsız olarak kanserli çocuklarda önemli bir hastalık ve ölüm nedenidir. Bu enfeksiyonlar, pandemi öncesine göre pandemi döneminde sokağa çıkma yasağı ve uzaktan eğitim nedeniyle daha az görüldü. Akut solunum yolu viral enfeksiyonları beş yaşın altındaki çocuklarda sıklıkla febril nötropeni ataklarına neden olur. Üç yıllık retrospektif kesitsel nitelikte olan bu çalışma üçüncü basamak bir üniversite hastanesinde yapıldı. Çocuk Hematoloji ve Onkoloji Bilim Dalı'nda akut solunum yolu viral enfeksiyonu tanısı alan kanserli çocuklar, nazofaringeal aspirat örneklerinde multipleks polimeraz zincir reaksiyonu (PCR) ile etken saptandıysa çalışmaya dahil edildi. Multipleks polimeraz zincir reaksiyonu ile on sekiz solunum virüsünün ve dört bakterinin kalitatif tespiti için test çalışıldı. Akut viral üst solunum yolu atağı geçiren 66 hasta bu çalışma dahil edildi. Doksan üç örneğin 70’i (%75) en az bir patojen için pozitifti. En yaygın üç virüs sırasıyla HRV, Influenza H1N1 ve Influenza H1N3’dü. COVID-19 dışında, kanserli çocuklarda ciddi akut solunum yolu viral enfeksiyonu riski her zaman önemlidir ve pandemi sırasında hijyen önlemleri ve sosyal kısıtlamalar, akut solunum yolu viral enfeksiyonu sayısında azalmaya neden olmuştur. Bu çalışma pandemi öncesi yakın dönemin akut viral üst solunum yolu enfeksiyonu geçiren kanserli çocuklarda etken dağılımı göstermesi nedeniyle önemlidir.

Anahtar Kelimeler:

covid 19, çocukluk çağı kanserleri, febril nötropeni, soulunum yolu enfeksiyonları

Epidemiology of acute respiratory viral infections of children with cancer before the COVID-19 pandemic

Children with cancer became a major high-risk group during the COVID-19 pandemic. It has become difficult for patients to reach practical and safe care and treatment all over the world. The late diagnosis of many childhood cancers was driven by limited access to healthcare due to the pandemic and fears of COVID-19 that prevented parents from making an early medical assessment of their child's symptoms. Acute respiratory diseases are an important cause of morbidity and mortality in children with cancer, regardless of the COVID-19 pandemic and were seen less frequently in the pandemic during the lockdown and distant education period in comparison to the time before the pandemic in children with cancer. Acute respiratory viral infections frequently cause febrile neutropenia attacks in children under five years of age. A three year retrospective cross-sectional study was performed in a tertiary care university hospital. Children with cancer who presented to the Department of Pediatric Hematology and Oncology with the diagnosis of acute respiratory viral infection were included in the study if they had available results of multiplex polymerase chain reaction (PCR) of nasopharyngeal aspirate samples. The qualitative detection of 18 respiratory viruses and four bacterias were detected by the real-time multiplex polymerase chain reaction. Sixty-six patients with 93 acute respiratory viral infection were included in this study. Seventy of 93 (75%) samples were positive for at least one pathogen. The most common three viruses were HRV, Influenza H1N1, and Influenza H1N3, respectively. Other than COVID-19, the risk of severe acute respiratory viral infections are always important in children with cancer and during the pandemic, hygiene measures and social restrictions caused a reduction in the number of acute respiratory viral infection. This study is critical because it shows the distribution of agents in children with cancer who had acute viral upper respiratory tract infections in the near term before the pandemic.

Keywords:

COVID-19, chilhood cancers, febrile neutropenia, respiratory infections,

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