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.