• Ondrej Hrusak, Tomas Kalina, Joshua Wolf, Adriana Balduzzi, Massimo Provenzi, Carmelo Rizzari, Susana Rives, María Del Pozo Carlavilla, Maria E V Alonso, Nerea Domínguez-Pinilla, Jean-Pierre Bourquin, Kjeld Schmiegelow, Andishe Attarbaschi, Pernilla Grillner, Karin Mellgren, Jutte van der Werff Ten Bosch, Rob Pieters, Triantafyllia Brozou, Arndt Borkhardt, Gabriele Escherich, Melchior Lauten, Martin Stanulla, Owen Smith, Yeoh Allen E J AEJ Yong Loo Lin School of Medicine and Cancer Science Institute, National University of Singapore, and Viva-University Children's Cancer Centre, National , Sarah Elitzur, Ajay Vora, Chi-Kong Li, Hany Ariffin, Alexandra Kolenova, Luciano Dallapozza, Roula Farah, Jelena Lazic, Atsushi Manabe, Jan Styczynski, Gabor Kovacs, Gabor Ottoffy, Maria S Felice, Barbara Buldini, Valentino Conter, Jan Stary, and Martin Schrappe.
• CLIP - Childhood Leukaemia Investigation Prague, Czech Republic; Department of Pediatric Hematology, Charles University and Univ. Hospital Motol, Prague, Czech Republic. Electronic address: Ondrej.Hrusak@lfmotol.cuni.cz.
• Eur. J. Cancer. 2020 Jun 1; 132: 11-16.

IntroductionSince the beginning of COVID-19 pandemic, it is known that the severe course of the disease occurs mostly among the elderly, whereas it is rare among children and young adults. Comorbidities, in particular, diabetes and hypertension, clearly associated with age, besides obesity and smoke, are strongly associated with the need for intensive treatment and a dismal outcome. A weaker immunity of the elderly has been proposed as a possible explanation of this uneven age distribution. Thus, there is concern that children treated for cancer may allso be at risk for an unfavourable course of infection. Along the same line, anecdotal information from Wuhan, China, mentioned a severe course of COVID-19 in a child treated for leukaemia.Aim And MethodsWe made a flash survey on COVID-19 incidence and severity among children on anticancer treatment. Respondents were asked by email to fill in a short Web-based survey.ResultsWe received reports from 25 countries, where approximately 10,000 patients at risk are followed up. At the time of the survey, more than 200 of these children were tested, nine of whom were positive for COVID-19. Eight of the nine cases had asymptomatic to mild disease, and one was just diagnosed with COVID-19. We also discuss preventive measures that are in place or should be taken and treatment options in immunocompromised children with COVID-19.ConclusionThus, even children receiving anticancer chemotherapy may have a mild or asymptomatic course of COVID-19. While we should not underestimate the risk of developing a more severe course of COVID-19 than that observed here, the intensity of preventive measures should not cause delays or obstructions in oncological treatment.Copyright © 2020. Published by Elsevier Ltd.

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