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INITIAL REPORT ON SPANISH PEDIATRIC ONCOLOGIC, HEMATOLOGIC AND POST STEM CELL TRANSPLANTATION PATIENTS DURING SARS-COV-2 PANDEMIC
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  • Anna Faura Morros,
  • Susana Rives Solà,
  • ALVARO LASSALETTA,
  • Elena Sebastián,
  • Luis Madero,
  • Jorge Huerta Aragonés,
  • Marina García-Morin,
  • Antonio Perez Martinez,
  • Luisa Sisinni,
  • Itziar Astigarraga,
  • Pablo Velasco,
  • Luis Gros,
  • Lucas Moreno,
  • Ana Carboné,
  • Carmen Rodriguez-Vigil,
  • Susana Riesco,
  • Maria del Carmen Mendoza Sanchez,
  • Elena Garcia Macias,
  • Maria Trabazo,
  • Montserrat Torrent,
  • Isabel Badell,
  • José Luis Fuster Soler,
  • Nerea Domínguez-Pinilla,
  • Antonio Juan Ribelles,
  • Vanesa Pérez-Alonso,
  • Manuel Fernández Sanmartin,
  • Marta Baragaño,
  • Maite Gorostegui,
  • Sara Perez-Jaume,
  • Ana Fernández-Teijeiro,
  • Andres Morales La Madrid,
  • Jose Luis Dapena
Anna Faura Morros
Hospital Sant Joan de Déu

Corresponding Author:[email protected]

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Susana Rives Solà
Hospital Sant Joan de Deu
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ALVARO LASSALETTA
Hospital Infantil Universitario Niño Jesús
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Elena Sebastián
Hospital Infantil Universitario Nino Jesus
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Luis Madero
Hospital Infantil Universitario Niño Jesús
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Jorge Huerta Aragonés
Hospital General Universitario Gregorio Marañón
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Marina García-Morin
Hospital General Universitario Gregorio Maranon
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Antonio Perez Martinez
Hospital Universitario La Paz
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Luisa Sisinni
Hospital Universitario La Paz
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Itziar Astigarraga
Hospital Universitario Cruces, Biocruces Bizkaia Health Research Institute, UPV/EHU
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Pablo Velasco
Hospital Universitari Vall d'Hebron
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Luis Gros
Hospital Universitari Vall d'Hebron
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Lucas Moreno
Vall d'Hebron Hospital
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Ana Carboné
Hospital Universitario Miguel Servet
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Carmen Rodriguez-Vigil
Hospital Universitario Miguel Servet
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Susana Riesco
Hospital Clínico de Salamanca
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Maria del Carmen Mendoza Sanchez
Hospital Clínico de Salamanca
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Elena Garcia Macias
Hospital Universitario Son Espases
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Maria Trabazo
Hospital de la Santa Creu i Sant Pau
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Montserrat Torrent
Hospital de la Santa Creu i Sant Pau
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Isabel Badell
Hospital de la Santa Creu i Sant Pau
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José Luis Fuster Soler
Hospital Clinico Universitario Virgen de la Arrixaca
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Nerea Domínguez-Pinilla
Hospital Virgen de la Salud
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Antonio Juan Ribelles
Hospital La Fe
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Vanesa Pérez-Alonso
Hospital Universitario 12 de Octubre
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Manuel Fernández Sanmartin
Hospital Clinico Universitario de Santiago de Compostela
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Marta Baragaño
Hospital Quirón Madrid
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Maite Gorostegui
Hospital Sant Joan de Deu
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Sara Perez-Jaume
Hospital Sant Joan de Deu
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Ana Fernández-Teijeiro
Complejo Hospitalario Virgen de la Macarena
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Andres Morales La Madrid
Hospital Sant Joan de Déu
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Jose Luis Dapena
Hospital Sant Joan de Déu
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Abstract

Background: Since the beginning of SARS-CoV-2 pandemic, it has been widely recognized that children and adolescents seem to have milder clinical courses as compared to adult counterparts. However, there is concern that vulnerable collectives including pediatric patients treated for cancer or under immunosuppression may be at higher risk. Methods: We retrospectively collected Spanish COVID-19 cases in children and adolescents with solid and hematological malignancies, non-malignant chronic hematologic conditions, and post allogeneic-stem cell transplantation, from the beginning of the pandemic on January 31 to April 24, 2020. Results: We included 47 cases with RT-PCR positive COVID-19 from 41 centers in Spain, where 97.6% of pediatric patients are treated for cancer. In most cases (76.6%), infection was asymptomatic, or symptoms were mild. Severe illness was observed in 14.9% of cases with respiratory distress and/or hypoxemia, and 8.5% required admission to the PICU. Symptomatic patients received supportive care associated with antiviral and immunomodulatory agents depending upon severity. Anticancer therapy was withhold in the majority of cases during the infection course. Most patients recovered from COVID-19. Two deaths were reported. Conclusion: In our cohort, most children receiving anticancer chemotherapy presented a mild clinical course and had a good outcome. Highly immunosuppressed patients with major comorbidities were at higher risk of severe infections. Among this fragile collective, individualized expert discussion is critical for anti-infectious therapy and appropriate anticancer treatment.