Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Assesment of one-year follow up of patients with Ecce-pciol surgery at University of Ilorin teaching hospital, Kwara State, Nigeria

Objectives: 1. To assess the visual outcome and complications during a one-year follow-up period of all patients who had extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens PCIOL implant. 2. To assess the average intraocular lens (IOL) power required to achieve emmetropia before the availability of the keratometer and A-Scan ultrasound machine in our centre. Materials and methods: All cases of ECCE-PCIOL done at the University of Ilorin Teaching Hospital, over a period of eighteen months (Jan 2001-July 2002) were included in the study. Visual acuity, ocular status and complications for each patient were assessed before the surgery and also at regular periods during the one-year follow-up. Results: A total of 105 patients (116 eyes) were operated. Eleven patients (9.4%) had bilateral surgery. The patients age range was 7-89 years with a mean of 64 years and a male to female ratio of 1:1.2. Sixty-six (57%) patients had right eye (RE) surgery, while 50 (43%) had left eye (LE) surgery; 98% of them had a preoperative visual acuity o