key: cord-0839549-m9gp0gpf
authors: Nazon, Charlotte; Velay, Aurélie; Radosavljevic, Mirjana; Fafi‐Kremer, Samira; Paillard, Catherine
title: Coronavirus disease 2019 3 months after hematopoietic stem cell transplant: A pediatric case report
date: 2020-07-06
journal: Pediatr Blood Cancer
DOI: 10.1002/pbc.28545
sha: b12746427a6306e7cf28f0633b87183f2730367a
doc_id: 839549
cord_uid: m9gp0gpf

nan

The American Society of Pediatric Hematology/Oncology

To the Editor:

Pediatric cases represent 1-5% of coronavirus disease 2019 (COVID-19) cases worldwide. 1 This is linked to the fact that infected children present asymptomatic or pauci-symptomatic forms and are therefore not tested, or children are less infected perhaps due to the lower expression level of angiotensin-converting enzyme 2 (ACE2) in their nasal mucosa. 2 As of now, the global register of pediatric oncology patients of St In this report, we describe the clinical course of a pediatric patient infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 3 months after hematopoietic stem cell transplant (HSCT). At that time, the patient was still treated with prednisolone (0.4 mg/kg/day) for her digestive GVHD, cyclosporine (4 mg/kg/day), ACE inhibitors (0.12 mg/kg/day), and preventive antiinfectious treatment by sulfamethoxazole-trimethoprime, posaconazole, phenoxymethylpenicillin, and valacyclovir. Complete blood count showed average hematological reconstitution with 3.5 × 10 9 /L white blood cells including 2.2 × 10 9 /L neutrophils, and preexisting lymphopenia (0.43 × 10 9 /L), hemoglobin 96 g/L, and platelets 53 × 10 9 /L ( Table S1 ).

on March 10 and April 9 (day 16) for immune deficiency secondary to HSCT. Immunophenotyping (Table S1) There are now several studies describing the kinetics of anti-SARS-CoV-2 IgM and IgG. Most report that IgM antibody is detectable 5-14 days after first symptoms. 10, 11 However, symptom severity may also affect the rate of seropositivity. A delayed or absent humoral response against SARS-CoV-2 has been reported in some patients 12 and may result in negative serology results. 13 Very little data are available on children with cancer, but it seems that in this fragile population COVID-19 is largely pauci-symptomatic.

In any event, clinical management in this population is a challenge because oncologic treatment is essential and cannot be postponed.

Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults

Nasal gene expression of angiotensin-converting enzyme 2 in children and adults

Global Registry of COVID-19 in Pediatric Cancer

SARS-CoV-2 infection in children

COVID-19 infection in children and adolescents with cancer in Madrid

Lessons after the early management of the COVID-19 outbreak in a pediatric transplant and hematooncology center embedded within a COVID-19 dedicated hospital in Lombardia, Italy. Estote parati

COVID-19 in children with cancer in New York city

COVID-19 in pediatric oncology from French pediatric oncology and hematology centers: high risk of severe forms? Pediatr Blood Cancer

Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study

Profiling early humoral response to diagnose novel coronavirus disease (COVID-19)

Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019

Early virus clearance and delayed antibody response in a case of COVID-19 with a history of co-infection with HIV-1 and HCV

Different longitudinal patterns of nucleic acid and serology testing results based on disease severity of COVID-19 patients

Immunology of COVID-19: current state of the science

Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study