key: cord-1010271-4w1qe7co
authors: Terenziani, Monica; Massimino, Maura; Biassoni, Veronica; Casanova, Michela; Chiaravalli, Stefano; Ferrari, Andrea; Luksch, Roberto; Meazza, Cristina; Podda, Marta; Schiavello, Elisabetta; Spreafico, Filippo
title: SARS‐CoV‐2 disease and children under treatment for cancer
date: 2020-05-06
journal: Pediatr Blood Cancer
DOI: 10.1002/pbc.28346
sha: c9c3a146514b7d4454cf9c0fcd2ecc2bf870198b
doc_id: 1010271
cord_uid: 4w1qe7co

nan

The American Society of Pediatric Hematology/Oncology

To the Editor: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has quickly raised a major concern for the safety of patients with cancer because of their immunosuppression.

Liang and colleagues noted that individuals with cancer are at higher risk of severe SARS-CoV-2 illness than those without cancer. 1 While recognizing that children seem to have a lower incidence of disease from SARS-CoV-2, 2-4 those with cancer carry a higher risk of morbidity and mortality from viral respiratory infections than their healthy peers. 5 Early contingency planning to contain this risk has been empirically implemented accordingly, but the issue of the distraction effect raised by Cortiula and colleagues deserves more attention. 6 Since many hospitals across the Lombardy region (in northern Italy, which has been the worst-hit area in Europe) were at the forefront in assisting patients with SARS-CoV-2, comprehensive oncology centers like ours have been appointed as reference hubs for continuing to deliver care to cancer patients. The Pediatric Unit at Fondazione IRCCS Istituto Nazionale Tumori (Milan) is one of the largest departments for children and adolescents with solid tumors in Europe, with >200 new cases yearly. We have consequently had the opportunity to manage a significant number of children and adolescents with solid tumors during this emergency.

At the time of writing (Table 1) It is worth noting that, following the Lombardy Health Authorities' guidelines, asymptomatic patients and health professionals were not routinely tested for SARS-CoV-2 at our hospital. To date, we have had no clinically evident SARS-CoV-2 infections among our children with cancer. While recognizing the low rate of viral testing as a possible bias, it is also true that-given the acknowledged low test rates-we might have expected a wider spread of the virus from asymptomatic caregivers to patients. 7 A substantial proportion of children with cancer are potentially curable. In this SARS-CoV-2 outbreak, a major risk for children and adolescents with cancer lies in the associated strain on the medical services. We wish to highlight the importance of a shared vision for providing cancer care to patients in the face of the uncertainty and rapid change prompted by these exceptional circumstances. Any emerging information is crucial to help us characterize the potential impact of SARS-CoV-2 in specific patient settings, 8 orient the implementation of contingency plans, and avoid measures that may be unduly restrictive of normal healthcare activities.

Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China

Coronaviruses and immunosuppressed patients. The facts during the third epidemic

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

SARS-CoV-2 infection in children

Prevalence and characteristics of acute respiratory virus infections in pediatric cancer patients

Managing COVID-19 in the oncology clinic and avoiding the distraction effect

Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2). Science

Early advice on managing children with cancer during the COVID-19 pandemic and a call for sharing experiences. Pediatr Blood Cancer