key: cord-0996441-devwqafd authors: de Rojas, Teresa; Pérez‐Martínez, Antonio; Cela, Elena; Baragaño, Marta; Galán, Victor; Mata, Cristina; Peretó, Alba; Madero, Luis title: COVID‐19 infection in children and adolescents with cancer in Madrid date: 2020-05-08 journal: Pediatr Blood Cancer DOI: 10.1002/pbc.28397 sha: d594e1d84eee5d28aa014efae3a3c463bf6879ad doc_id: 996441 cord_uid: devwqafd nan To the Editor: 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, 1-3 0.8% in Madrid. 4 Although children with cancer are considered a high-risk population, data specifically addressing the pediatric oncology population are still limited. 3, 5 We present a case series of all pediatric oncology patients infected with COVID-19 in Madrid to date to provide updated epidemiological data and to describe the most relevant clinical features and outcomes. All pediatric oncology patients (0-18 years) with proven infection of COVID-19 in Madrid up to April 15, 2020 were identified and included. Approval was obtained by the local Ethics Committee. The total number of current pediatric oncology patients in the Madrid region was estimated through 2015-2019 data from the Madrid Tumor Registry "RTMAD." 6 The main patient (n = 15) characteristics are shown in Table 1 . Median age was 10.6 years (range 0.6-18.6). The cancer types included hematological malignancies (73%, 11) and solid tumors (27%, four). Additionally, all patients were tested by polymerase chain reaction, which continues to be the gold standard and, in our opinion, should not be substituted by rapid serology-based testing in the pediatric oncology population. 7 The COVID-19 infection prevalence among adult cancer patients has been reported to be higher than in the general population (1% vs 0.29%). 8 No robust data exist to date regarding the infection prevalence in pediatric cancer patients. In our series, the estimated 1.3% is difficult to compare with the general pediatric population, estimated 0.8% in Madrid, 4 since the latter is likely to be underestimated. In spite of these limitations, the incidence seems higher in children and adolescents with cancer. A worrisome finding is the high proportion of patients (27%) that presented with nosocomial infection. The infection rates of health care professionals in Spain have been among the highest in the world, 9, 10 which may explain the proportion of nosocomial infection. The clinical, radiological, and laboratory findings are similar to previously published data for the general pediatric population. 1, 3 Although there is no solid evidence for the treatment of the COVID- 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 Screening and severity of coronavirus disease 2019 (COVID-19) in children in Madrid Early advice on managing children with cancer during the COVID-19 pandemic and a call for sharing experiences. Pediatr Blood Cancer Comment on: Early advice on managing children with cancer during the COVID-19 pandemic and a call for sharing experiences. Pediatr Blood Cancer Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China España bordea los 10.000 sanitarios infectados por Covid-19 Situación de COVID-19 o Coronavirus en España Antonio Pérez-Martínez and Elena Cela contributed equally to this work.