Brazil is the largest country in South America with continental
dimensions and significant regional differences. Recently, the country
has faced a great challenge in establishing adequate strategies to
mitigate the strong impact caused by the arrival of COVID-19 in the
national territory. Since the first case diagnosed on February 26th,
2020, we have gone through a 18 week period that resulted in 58.300
deaths and more than 1.370.000 confirmed cases¹. Despite having a public
and universal health system, most pediatric oncology centers are located
in more urbanized regions, such as state capitals or economic centers.
Few reports describe the impact of SARS-CoV-2 on the population of
pediatric patients accompanied by cancer or undergoing hematopoietic
stem cell transplantation (HSCT)2,3,4. Less frequent
still are the descriptions of the situation of these children in low or
middle income countries⁵. Faced with this new and unknown scenario, the
present study aims to describe the clinical presentation and the
evolution of children affected by COVID-19 undergoing treatment in units
of oncology, hematology or HSCT. We are analyzing the interregional
differences in the presentation, management and prognosis of these
children, while drawing a national panorama that can be compared with
other countries through a national and multicenter registry of children
evaluated for SARS-CoV-2.
Through dissemination by the Brazilian Society of Pediatric Oncology
(SOBOPE), Brazilian Association of Hematology and Hemotherapy (ABHH) and
Brazilian Society of Bone Marrow Transplantation (SBTMO). 36 centers
across the country agreed to participate in this project (Figure 1). All
regions of the country are included. The variables evaluated are
clinical symptoms, diagnostic method, therapeutic measures and treatment
location. In addition, the repercussions of infection on baseline
treatment and overall prognosis are being assessed. Despite being in an
initial phase, the database already counts with 64 registered cases.
This joint work of the centers for pediatric oncology and bone marrow
transplantation in our country is an advance that is allowing the
development of one of the largest databases on the influence of COVID19
in the treatment of children in developing countries. Considering the
small number of current literature on this subject, the heterogeneity of
our population and regional differences, centralization of records is
essential to better understand the extent and impact of this epidemic in
our country, in addition to comparing the effect of local health
strategies. It is important to highlight that the Sistema Único de Saúde
(SUS), one of the largest and most complex public health systems in the
world, guarantees universal health care and presents itself as a
significant differential in combating the pandemic in Brazil through
primary care, as well as medium and high complexity assistance.
The development of this study will contribute to a better understanding
of the clinical presentation, evolution and impact of that of COVID-19
in pediatric cancer patients or those undergoing HSCT in middle-income
countries.