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. 2022 Oct;69(10):e29748.
doi: 10.1002/pbc.29748. Epub 2022 May 20.

Impact of COVID-19 in pediatric oncology care in Latin America during the first year of the pandemic

Gabriela Villanueva  1 , Claudia Sampor  2 , Julia Palma  3 , Milena Villarroel  3 , Diana Valencia  4   5 , Mercedes García Lombardi  6 , Wendy Gomez Garcia  7 , Eva Lezcano Caceres  8 , Victoria Sobrero  9 , Lilia Garcia  10 , Victor Cabrera  11 , Ivan Maza  12 , Thelma Velasquez  13 , Cecilia Ugaz  14 , Jacqueline Montoya Vasquez  14 , Rosdali Diaz Coronado  14 , Natalia Gonzalez  15 , Simone Aguiar  16 , Agustin Dabezies  17 , Florencia Moreno  18   19 , Susan Sardinas  20 , Yessika Gamboa  21 , Essy Maradiegue  22 , Ligia Fu  23 , Pascale Gassant  24 , Katiuska Moreno  25 , Oscar Gonzales  26 , Magdalena Schelotto  27 , Sandra Luna-Fineman  28   29 , Celia Gianotti Antoneli  30 , Soad Fuentes-Alabi  31   32 , Silvana Luciani  31 , Andrea Cappellano  33 , Guillermo Chantada  1   27   34 , Liliana Vasquez  31   35
Affiliations

Impact of COVID-19 in pediatric oncology care in Latin America during the first year of the pandemic

Gabriela Villanueva et al. Pediatr Blood Cancer. 2022 Oct.

Abstract

Background: The ongoing coronavirus 2019 disease (COVID-19) pandemic strained medical systems worldwide. We report on the impact on pediatric oncology care in Latin American (LATAM) during its first year.

Method: Four cross-sectional surveys were electronically distributed among pediatric onco-hematologists in April/June/October 2020, and April/2021 through the Latin American Society of Pediatric Oncology (SLAOP) email list and St Jude Global regional partners.

Results: Four hundred fifty-three pediatric onco-hematologists from 20 countries responded to the first survey, with subsequent surveys response rates above 85%. More than 95% of participants reported that treatment continued without interruption for new and active ongoing patients, though with disruptions in treatment availability. During the first three surveys, respondents reported suspensions of outpatient procedures (54.2%), a decrease in oncologic surgeries (43.6%), radiotherapy (28.4%), stem cell transplants (SCT) (69.3%), and surveillance consultations (81.2%). Logistic regression analysis showed that at the beginning of the first wave, participants from countries with healthcare expenditure below 7% were more likely to report a decrease in outpatient procedures (odds ratio [OR]: 1.84, 95% CI: 1.19-2.8), surgeries (OR: 3, 95% CI: 1.9-4.6) and radiotherapy (OR: 6, 95% CI: 3.5-10.4). Suspension of surveillance consultations was higher in countries with COVID-19 case fatality rates above 2% (OR: 3, 95% CI: 1.4-6.2) and SCT suspensions in countries with COVID-19 incidence rate above 100 cases per 100,000 (OR: 3.48, 95% CI: 1.6-7.45). Paradoxically, at the beginning of the second wave with COVID-19 cases rising exponentially, most participants reported improvements in cancer services availability.

Conclusion: Our data show the medium-term collateral effects of the pandemic on pediatric oncology care in LATAM, which might help delineate oncology care delivery amid current and future challenges posed by the pandemic.

Keywords: COVID-19; Latin America; healthcare delivery; low- and middle-income countries; pediatric cancer; survey.

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Conflict of interest statement

Guillermo Chantada receives fees from Bayer and Elea‐Phoenix (Argentina) and participates on the data safety monitoring board or advisory board for Bayer (Larotrectinib). Sandra Luna‐Fineman receives personal fees from Riverboat Study (Research into Visual endpoints and Rb Health outcomes ‐ 5R01CA225005‐03 ‐ salary support), WHO NCD Childhood Cancer ‐ consultant (salary support), St Jude Global consultant, St Jude Children's Research Hospital, Global Retinoblastoma studies (salary support). Sandra Luna‐Fineman is also a SLAOP Board member and works at the Retinoblastoma Advisory Committee, St Jude Global Alliance, St Jude Children's Research Hospital. All the remaining authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Proportion of responses on childhood cancer treatments disruptions (total or partial suspensions) during the first year of COVID‐19 pandemic in all participating Latin American countries
FIGURE 2
FIGURE 2
South America. Proportion of responses on treatments disruptions (total or partial suspensions) per survey and per country, compared to number of COVID‐19 cases per day in each country
FIGURE 3
FIGURE 3
Central America. Proportion of responses on treatments disruptions (total or partial suspensions) per survey and per country, compared to number of COVID‐19 cases per day in each country
FIGURE 4
FIGURE 4
Effect of COVID‐19 pandemic on treatment abandonment, delays in diagnosis, and increase in out‐of‐pocket expenses during the first year of the pandemic: 33% of participants reported that delays in diagnosis occurred very frequently; 17.2% of participants reported that treatment abandonment occurred very frequently during the pandemic; and 42.4% of participants reported an increase in family out‐of‐pocket expenses
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