SARS-CoV-2 Infection in the Pediatric Oncology Population: The Definitive Comprehensive Report of the Infectious Diseases Working Group of AIEOP

Objective: The objective of this study was to assess the clinical impact and outcome of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection on children with cancer or who received a hematopoietic stem cell transplantation (HSCT). Study design: The Italian Association of Pediatric Hematology and Oncology (AIEOP) performed a nationwide, multicenter, observational cohort study, including consecutive patients between April 2020 to November 2022. Results: Twenty-five Italian centers participated and 455 patients were enrolled. We reported a significative increasing trend of symptomatic cases over the years, while the number of non-mild infections remained stable. An early infection after the oncological diagnosis (<60 days) and severe neutropenia have been identified as independent risk factors for developing moderate, severe or critical infections. The percentage of asymptomatic and mildly symptomatic patients who stopped chemotherapy reduced over the years of the pandemic. Nine patients died, but no death was attributed to SARS-CoV-2 infection. Conclusions: SARS-CoV-2 infection presented a self-limiting, benign course in the Italian pediatric onco-hematology population during the pandemic and its main consequence has been the discontinuation of cancer-directed therapies. The rate of asymptomatic patients who stopped chemotherapy reduced over the years, suggesting that the continuation of chemotherapy is a feasible option.