key: cord-1050287-lha8iolc
authors: Jarvis, Kirsten Brunsvig; Lind, Andreas; LeBlanc, Marissa; Ruud, Ellen
title: Observed reduction in the diagnosis of acute lymphoblastic leukaemia in children during the COVID‐19 pandemic
date: 2020-10-05
journal: Acta Paediatr
DOI: 10.1111/apa.15576
sha: f046f91f3f9c65a50750dec77813e361979dec25
doc_id: 1050287
cord_uid: lha8iolc

To contain the spread of the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), the Norwegian government implemented lock-down restrictions from 13.03.2020: schools, day cares and after-school activities were closed, 2-week quarantine was required following international travel, physical distancing (2 metres) was recommended and groups were restricted to 5 people.

To contain the spread of the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 , the Norwegian government implemented lockdown restrictions from March 13, 2020: schools, day cares and after-school activities were closed, 2-week quarantine was required following international travel, physical distancing (2 m) was recommended, and groups were restricted to five people. 1 Simultaneously, there was great focus on personal hygiene recommendations. From the end of April, the restrictions were gradually scaled back with reopening of schools and day cares, physical distancing reduced to 1 m and groups up to 20 people allowed. The advice to stay home in case of respiratory symptoms or fever remained. New daily cases of SARS-CoV-2 infection fell nationally from maximum 297 in March 26, 2020, to 10-20 in June and July. In parallel, the number of diagnosed airway infections with other pathogens fell rapidly, probably reflecting the implemented lockdown measures. Acute respiratory infection is the most common illness in children. 2 We investigated the effect of the There have been reports of a reduction in paediatric solid tumours, both from Milano, Italy, and New York, USA. 4,5 New York but not Milano observed an increase in metastatic cases.

During the SARS-epidemic in Hong Kong in 2003, which also lead to a lockdown of society, a decrease in new ALL cases in young children was seen. 6 This was hypothesised to be related to common infections playing a role in ALL development. Though we have seen a decrease in airway pathogens, we do not have a direct measure of common infections in society and we are limited by small numbers of ALL cases. The drop in ALL cases was observed from the beginning of the lockdown though one might have expected some latency; however, there had already been changes in behaviour in society before the lockdown was implemented. In addition to infection, there may have been reduced contact with other environmental factors potentially involved in leukaemogenesis during the lockdown. The role of infectious disease in ALL development is not clear, but the social experiment of the COVID-19 lockdown might give an indication when different experiences around the world are compared, for example in a large multicentre study including regions with and without lockdown.

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