Case 2
A 3-year-old child with stage 4 neuroblastoma was being treated as per
OPEC/OJEC protocol. After 4 cycles of chemotherapy he underwent surgical
resection of primary right suprarenal tumor. He achieved very good
partial remission. Two weeks after surgery on screening for SARSCOV2
prior to chemotherapy PCR test came positive (Ct values N-14.59
ORF-16.84 S-17.48). As he was asymptomatic so he was isolated at home
for 2 weeks and chemotherapy was postponed. His TLC was
9630/mm3 and ANC
-7400/ mm3 and ALC-970/ mm3. Two
weeks later repeat PCR test (using Siemens FTD SARSCOV2 RTPCR kit) was
still positive (Ct value-32.39). We repeated test again after 1 week and
it came negative. Child was given next course of chemotherapy OJEC.
Three weeks later prior to next chemotherapy PCR (using Siemens Labgun
exofast RTPCR kit) was again positive (Ct values, N-22.37 RdRp-22.15)
and IgG antibody (quantitative assay by CLIA technology for quantitative
determination of anti S1 and anti S2 specific IgG against SARSCOV2) was
positive 306 AU/ml. Gap between first and second infection was 42 days.
He was isolated at home for another 2 weeks and after that repeat PCR
was negative. Child was restarted chemotherapy as per protocol.