clinical characteristics and outcomes of covid-19 in pediatric cancer patients: a retrospective cohort study

Background: the impact of covid-19 on pediatric cancer patients remains a critical area of investigation. objectives: this study aimed to compare the clinical characteristics and outcomes of covid-19 in children with and without malignancies. methods: a retrospective cohort study was conducted at mofid children's hospital in tehran, iran, from july 2020 to december 2022. the study included 210 children with confirmed sars-cov-2 infection: 105 with malignancies (case group) and 105 without malignancies (control group). clinical presentations, laboratory parameters, imaging findings, and outcomes were analyzed. results: children with malignancies exhibited lower rates of fever (p = 0.044), respiratory distress (p = 0.035), and nausea/vomiting (p = 0.002). significant differences in laboratory findings were observed between the case and control groups, including wbc count (p = 0.007), hemoglobin levels (p < 0.001), platelet count (p = 0.002), and esr (p = 0.001). ground-glass opacity on chest imaging was significantly associated with malignancy (p = 0.003). although not statistically significant, the malignancy group showed a trend toward higher mortality (or = 2.686, p = 0.105). thrombotic events were rare in both groups. conclusions: pediatric cancer patients with covid-19 exhibited more severe symptoms and distinct laboratory and imaging findings compared to non-cancer patients. while mortality rates were similar, the trend toward higher risk in the malignancy group highlights the need for specialized management strategies for this vulnerable population.