key: cord-0861827-tzhdvx2i authors: André, Nicolas; Rouger‐Gaudichon, Jérémie; Brethon, Benoît; Phulpin, Aurélie; Thébault, Éric; Pertuisel, Sophie; Gandemer, Virginie title: COVID‐19 in pediatric oncology from French pediatric oncology and hematology centers: High risk of severe forms? date: 2020-05-08 journal: Pediatr Blood Cancer DOI: 10.1002/pbc.28392 sha: 0f3760f67940ba3756536b84621edc0855da94f3 doc_id: 861827 cord_uid: tzhdvx2i nan To the Editor: The rapid spread of the coronavirus disease 2019 (COVID-19) pandemic has rapidly led to the establishment of social distancing measures on a global scale to try to protect the general population as well as patients. 1 An unprecedented wave of dedicated preclinical and clinical research projects has also been launched. 2 While children seem to be less at risk than adults, infants and younger children ≤5 years are more likely to develop a severe form of COVID-19 compared with children ≥6 years. 3 The specific risks for patients in pediatric oncology patients are not well known. However, due to treatment-induced immune depression, the risks may be higher in this population, and recommendations have been proposed. 4 However, no alarming reports have emerged from countries that have been facing the COVID-19 epidemic so far, such as China, Spain, or Italy. 5 A recent review reported two severe pediatric cases of COVID-19 in China but these children were not treated for malignancies. 6 France is currently fighting the pandemic and has nearly 140 000 cases of COVID-19 and 15 000 deaths. 7 recently underwent an allogeneic HSCT for a sickle cell disease. The last patient is a 7-year-old girl diagnosed with a progressive highgrade glioma with an altered general condition. All patients have been transferred to ICU for a rapid respiratory degradation, mostly after a first phase with mild symptoms. At the time of writing, there was no death to report. One patient has recovered and was discharged from ICU. It is too early to give definitive outcomes for these patients. We will be able to gain more insight of the impact of COVID-19 in pediatric oncology as COVID-19 continues to spread and more data are collected. While the first data collected by the SFCE are preliminary, we thought they should be quickly shared with the pediatric oncology community. Our first data are consistent with a previous report in which, among 171 children diagnosed with COVID-19, one patient with leukemia required intensive care support and invasive mechanical ventilation. 8 Although COVID-19 in pediatric oncology patients appears to be rare, all stakeholders from physicians to patients and their families should be aware of a higher risk of severe forms compared to immunocompetent children. Nicolas André, Jérémie Rouger-Gaudichon, and Virginie Gandemer conceived the work and wrote the manuscript. Sophie Pertuisel, Benoît Brethon, Eric Thebault, and Aurélie Phulpin shared data about the patients described, helped to improve, and approved the manuscript. The authors declare that there is no conflict of interest. The pandemic in pictures: how coronavirus is changing the world Tens of thousands of scientists are redeploying to fight coronavirus Epidemiology of COVID-19 among children in China Standardized management guideline for pediatric wards of hematology and oncology during the epidemic of coronavirus disease Early advice on managing children with cancer during the COVID-19 pandemic and a call for sharing experiences COVID-19 epidemic: disease characteristics in children COVID-19 Map Johns Hopkins Coronavirus Resource Center. COVID-19 Map Chinese Pediatric Novel Coronavirus Study Team, et al. SARS-CoV-2 infection in children