key: cord-1011019-k4i15gyg
authors: Flores, Victoria; Miranda, Raquel; Merino, Laura; González, Carmen; Serrano, Cristina; Solano, Moises; Herrera, Jessica; González, Paulina; Ruiz, Genesis; Saldaña, Ricardo; Cárdenas, Ahtziri; Chávez-Aguilar, Lénica A.
title: SARS-CoV-2 infection in children with febrile neutropenia
date: 2020-06-12
journal: Ann Hematol
DOI: 10.1007/s00277-020-04115-1
sha: 8754c53bfffdc51cf75c266efb63c812d1acf7cf
doc_id: 1011019
cord_uid: k4i15gyg

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No other site of infection was found in our patients, the procalcitonin value did not suggest bacterial infection, and no microorganism was identified on blood cultures. Patients 1 and 2 had a hospital stay of 2 weeks; they remained hospitalized because of the uncertainty regarding their clinical evolution due to the lack of medical reports of COVID-19 in patients with ALL and FN. Patient 3 required invasive mechanical ventilation, furthermore, she deteriorated hemodynamically and presented cardiac arrest that did not respond to cardiopulmonary resuscitation.

Patients 1 and 2 were treated with enoxaparin, even though they did not meet criteria for disseminated intravascular coagulation. This treatment was given due to the multiple alterations in coagulation associated with worse prognosis that have been described in patients with COVID-19 [5, 6] . Our patients presented elevation of D-dimer, which is suggestive of thrombotic activity and severe inflammatory process. Patient 3 did not receive thromboprophylaxis due to severe thrombocytopenia.

We present this first experience in Mexican children with FN and ALL. COVID-19 should be suspected in children with FN even in the absence of other symptoms. The prognosis of these patients remains uncertain and larger series reporting the course of SARS-CoV-2 infection in children with hematooncological diseases are needed to develop specific clinical guidelines.

Conflict of interest The authors declare that they have no conflict of interest.

Ethical approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the Helsinki declaration. tional claims in published maps and institutional affiliations. 

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