key: cord-0884105-116lq4dr authors: Arous, Radjaa; Djillali, Imene Sarah; Rouis, Nassiba Ould; Boudiaf, Houda; Amhis, Wahiba; Ziane, Hanifa; Ladj, Mohamed Samir; Boukari, Rachida title: High mortality of COVID‐19 in children with cancer in a single center in Algiers, Algeria date: 2021-02-19 journal: Pediatr Blood Cancer DOI: 10.1002/pbc.28898 sha: a83e7f4592f4af3f6cec81b56089eefff453efe7 doc_id: 884105 cord_uid: 116lq4dr nan To the Editor: Algeria has been severely affected by the COVID-19 pandemic, with 42 228 cases and 1416 deaths (February 25 to August 25, 2020), and one of the highest incidences of COVID-19 in Africa. 1 The incidence of COVID-19 is remarkably less in the pediatric population than in the adult population, with children accounting for 1-5% of diagnosed cases. [2] [3] [4] Children with cancer remain at high potential risk of acquiring infectious diseases, including COVID-19. However, the current number of reported cases of COVID-19 among these patients is limited. The risk of severe disease with COVID-19 in profoundly immunocompromised children is still unknown, and predictors of the severity of the disease would help support the development of approaches to prevent and to optimize treatment of COVID-19 in this vulnerable patient population. Recent publications suggest that the pediatric oncology population may not have higher mortality resulting from SARS-CoV-2 infection in high-income countries such as Spain, China, USA, Italy, and France. [5] [6] [7] [8] [9] We present a case series of pediatric oncology patients infected with COVID-19 in the Pediatric Oncology Department of the University Hospital Mustapha Bachain Algiers during the period from June 1 to August 31, 2020. During the study period, there were 258 accesses for inpatients registered and 183 for outpatients. Overall, 17 patients and 17 parents were tested for COVID-19 (nasopharyngeal swab reverse transcriptase polymerase chain reaction). Twentysix were asymptomatic (tested due to close contact with diagnosed cases) and eight were symptomatic (four parents and four patients). Seven cases of proven COVID-19 were identified: three males and four females, with a median age of 5 years (range 1-16). The cancer types included hematological malignancies (six cases) and neuroblastoma (one case). The main patient characteristics are shown in Table 1 . Five patients were family-clustered cases and had a close contact history with confirmed or suspected COVID-19 patients; two were infected during hospitalization. Six of these patients were on treatment, and one had completed treatment and was in follow-up. The most frequent symptoms were fever and cough (four cases), followed by diarrhea (two cases), skin lesions (one case), and seizures (one case); three patients were asymptomatic. Chemotherapy was stopped in all the cases. Most patients received azithromycin, three of them in different combinations (including hydroxychloroquine, corticosteroids, and anakinra). Three patients required oxygen therapy and were transferred to the COVID-19 unit of the pediatric department. None World Health Organization. Coronavirus Disease (COVID-19) Pandemic. WHO; 2020 Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China Clinical characteristics of coronavirus disease 2019 in China Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults COVID-19 infection in children and adolescents with cancer in Madrid COVID-19 epidemic: disease characteristics in children COVID-19 in children with cancer Children with cancer in the time of COVID-19: an 8-week report from the six pediatric onco-hematology centers in Lombardia, Italy. Pediatr Blood Cancer COVID-19 in pediatric oncology from French pediatric oncology and hematology centers: high risk of severe forms 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 Challenges posed by COVID-19 to children with cancer