Abstract
OBJECTIVE: This study aims to understand the impact of the COVID-19 pandemic on the diagnosis, management, and clinical outcomes of children and young people (CYP) with brain tumours in England. DESIGN: UK-based retrospective observational study with two components. Nationwide brain tumour incidence data from the National Disease Registration Service was obtained (2015-2020) to study trends in newly diagnosed cases. Regional data from three paediatric neurosurgical centres was used to compare CYP newly diagnosed with a brain tumour before and those during the pandemic (March 2019-February 2021). PARTICIPANTS: No change in national incidence during the first year of the pandemic was seen. Regional data totalled 159 CYP, 88 diagnosed before the pandemic, 71 during (median age 7.0 years before, 7.8 years during the pandemic). RESULTS: The commonest tumour types in both groups were low grade glioma (including pilocytic astrocytoma), medulloblastoma, and ependymoma. Symptoms at diagnosis were similar, the commonest overall being headache (52.3 vs 50.7%). Number of symptoms at diagnosis was comparable. Rates of complications (28.4 vs 40.8%, p = 0.129) and poor outcome (13.6 vs 22.5%; p = 0.143) were not significantly different. Time to diagnosis and treatment were similar between cohorts. CONCLUSION: This is the first UK study investigating the effects of the COVID-19 pandemic on CYP with a new brain tumour diagnosis. CYP diagnosed during the pandemic had comparable clinical presentations, times to diagnosis and treatment, and clinical outcomes. This suggests that acute paediatric neuro-oncology services were resilient in the face of pandemic-related restrictions and service adaptations.