Results
Up to the 28th of May 2020, 41 patients with COVID-19
have been declared in SFCE centers. Most of patients were from Eastern
France and the region around Paris, consistent with the distribution of
the epidemic in whole population (Figure 1). Thirty-seven patients were
included in the study. The main characteristics of patients are shown in
Table 1. Of the 37 patients, 31 were children under the age of 18 (mean:
11.2 years [1-25]). Nineteen patients (51%) were female. Seventeen
patients had a solid tumor, 16 had a hematological malignancy and four
recently underwent HSCT for non-oncological conditions. Nine patients
were treated for a cancer relapse. Contact with an infected person was
reported for 19 patients, with a median estimated incubation period of
9.5 days (data available for 10 patients). Twenty-eight patients
presented symptoms (Table 2). All patients were tested for SARS CoV-2
infection by PCR on a nasopharyngeal swab, which was positive in 34
patients (92%). Two patients were diagnosed with positive specific IgM
serology and one patient was diagnosed upon typical clinical and
radiological findings. Thoracic computed tomography-scan was performed
in fifteen patients and was abnormal in all but one case. Ground-glass
opacities were the most frequent abnormality (9 cases). Abnormalities
were mostly bilateral and peripherally distributed. Blood count results
were available for 31 patients. Lymphopenia below 0.5 G/L was found in
thirteen patients. Neutropenia below 0.5 G/L was found in thirteen
patients. Six patients presented concomitant neutropenia and
lymphopenia. C-reactive protein (CRP) dosage results were available for
24 patients. Fifteen patients had an elevated CRP, with a CRP mean level
of 41.6 mg/L [15-280]. Four patients had a CRP above 50 mg/L. Liver
enzymes were measured in seventeen patients, nine of whom had elevations
greater than twice the upper limit of normal. A co-pathogen was found in
blood samples of two patients (one with Staphyloccocus Epidermidis, and
one with Epstein-Barr virus). Twenty-four patients received
chemotherapy, on average 12.6 days [0-35] prior to COVID-19
diagnosis, with a mean number of drugs of 2.1 [1-5]. Nine patients
were currently (or recently) treated with less than 1 mg/kg/day of
corticosteroids, five with cyclosporin A and one with tacrolimus. Most
patients did not require hospitalization to manage COVID-19. Seventeen
patients received antibiotics, with ten patients presenting febrile
neutropenia. Only one patient received remdesivir and three received
hydroxychloroquine outside of a clinical trial. Three patients required
oxygen at the time of diagnosis and two of them were transferred in an
intensive care unit (ICU). In total, five patients were admitted in an
ICU because of COVID-19 and one died from the disease. Their main
characteristics are described in Table 3. Of note, four patients had
been heavily treated for their cancer and/or recently underwent HSCT.
Except for these patients, there were only asymptomatic to moderate
forms of infection, with a median follow-up of 21 days [0-58]. For
the 13 patients for whom PCR had been repeated and this data was
available, the mean time to a negative PCR was 16.5 days [7-28].
COVID-19 delayed oncology treatment in 16 patients for an average of 14
days.