key: cord-0763902-vlqya9wu authors: Chiaravalli, Stefano; Ferrari, Andrea; Sironi, Giovanna; Gattuso, Giovanna; Bergamaschi, Luca; Puma, Nadia; Schiavello, Elisabetta; Biassoni, Veronica; Podda, Marta; Meazza, Cristina; Spreafico, Filippo; Casanova, Michela; Terenziani, Monica; Luksch, Roberto; Massimino, Maura title: A collateral effect of the COVID‐19 pandemic: Delayed diagnosis in pediatric solid tumors date: 2020-08-06 journal: Pediatr Blood Cancer DOI: 10.1002/pbc.28640 sha: fcc513cbbf9ea3aa36fe0720c46d842e742fdca7 doc_id: 763902 cord_uid: vlqya9wu nan To the Editor: The COVID-19 pandemic has become a huge health emergency. In the world of pediatric oncology, we have had to profoundly modify our habits regarding the management of patients and their families. We have had to focus on minimizing the risk of the virus spreading within the hospital while ensuring the best possible management of cases found positive for COVID-19 and, above all, on assuring our children and adolescents that they will receive the oncological care they need. [1] [2] [3] [4] Meanwhile, during the 8-week lockdown imposed in Italy to cope with the peak of the epidemic, we noted a reduction in the number of pediatric tumors being newly diagnosed, probably reflecting delayed access to health care services for patients with signs and symptoms We also considered our patients' regions of provenance, bearing in mind that, judging from data collected for the whole year of 2019, we would have expected 74% of our patients to come from northern Italy, 5% from central Italy, 18% from southern Italy, and 3% from abroad. Among the 16 cases seen during the lockdown period, all but two of them were from Lombardy (the region where our center is located). Assuming that any drop in the diagnostic rate might be followed by a rebound, we then analyzed the number of new cases diagnosed in the subsequent 8-week period (from May 4 to June 28, 2020). As shown in Table 1 Children with cancer in the time of COVID-19: an eight-week report from the six pediatric onco-hematology centers in Lombardia How young patients with cancer perceive the Covid-19 (coronavirus) epidemic in Milan, Italy: is there room for other fears? Pediatr Blood Cancer SARS-CoV-2 disease and children under treatment for cancer On the clinical psychologist's role in the time of COVID-19, with particular reference to experience gained in pediatric oncology The outbreak of novel coronavirus disease (COVID-19) caused a worrying delay in the diagnosis of oral cancer in north-west Italy: the Turin Metropolitan Area experience Cancer diagnostic rates during the 2020 'lockdown' , due to COVID-19 pandemic, compared with the 2018-2019: an audit study from cellular pathology SARS-CoV-2 infection anxieties and general population restrictions delay diagnosis and treatment of acute haematological malignancies Delayed access or provision of care in Italy resulting from fear of COVID-19 Delayed referral of pediatric brain tumors during COVID-19 pandemic Delayed cancer diagnoses and high mortality in children during the COVID-19 pandemic. Pediatr Blood Cancer. 2020:e28427 Beware of time delay and differential diagnosis when screening for symptoms of COVID-19 in surgical cancer patients Effect of COVID-19 epidemic on delay of diagnosis and treatment path for patients with nasopharyngeal carcinoma Delays in diagnosis and treatment among children and adolescents with cancer in Canada Symptom interval in pediatric patients with solid tumors: adolescents are at greater risk of late diagnosis The sooner the better? How symptom interval correlates with outcome in children and adolescents with solid tumors: regression tree analysis of the findings of a prospective study